[Mitral valve function after open mitral commissurotomy: assessment by Doppler echocardiography]

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Surgery

Background:

• Open mitral commissurotomy (OMC) is a surgical procedure to treat mitral valve stenosis.
• Long-term functional outcomes and potential complications like mitral regurgitation (MR) after OMC require thorough evaluation.

Purpose of the Study:

• To assess long-term mitral valve function following open mitral commissurotomy (OMC).
• To evaluate the incidence and severity of mitral regurgitation (MR) after OMC.
• To determine the correlation between time elapsed since OMC and echocardiographic parameters.

Main Methods:

• Doppler echocardiography was utilized in 39 patients (13 males, 26 females) with a total of 83 post-operative examinations.
• Continuous wave Doppler (CWD) measured transmitral blood flow velocity.
• Transmitral pressure half time (PHT), mean velocity (mV), and peak velocity (pV) were calculated; mitral regurgitation (MR) severity was assessed using color flow mapping.

Main Results:

• A significant positive correlation was observed between PHT and months passed after OMC (r = 0.63, p < 0.001), described by the regression line PHT = 0.70 x PMo + 83.
• Mean velocity (mV) and peak velocity (pV) showed a gradual increasing trend but did not significantly correlate with postoperative time.
• Mitral regurgitation (MR) was present in 72% of patients post-OMC. Among those without pre-operative MR, 57% developed MR post-surgery.

Conclusions:

• Open mitral commissurotomy is associated with a progressive increase in transmitral pressure half time over the long term.
• Mitral regurgitation is a common finding after OMC, frequently developing or persisting post-operatively.
• Doppler echocardiography is crucial for monitoring long-term mitral valve function and MR after OMC.