[Doppler echography in the evaluation of mitral valve function following Carpentier's valvuloplasty]

In the present study Doppler-echocardiography was used to evaluate the quality of mitral valve regurgitation (MVR) repair by Carpentier valvuloplasty. Between January, 1984 and June, 1987, this operation was performed in 51 patients (39 men, 12 women; mean age 58 +/- 10.9 years) presenting with mitral valve regurgitation; 25 were in class III and 14 in class IV of the NYHA classification. Two patients died soon after the operation and 2 others some time later. The 47 survivors were followed up for a mean period of 20.5 +/- 11.2 months: 3 of them required mitral valve replacement for residual MVR or mitral stenosis, one developed cerebral embolism. At the latest control, 18 patients were in NYHA class I and 26 in NYHA class II. Doppler velocimetry showed no or little mitral valve dysfunction; the residual MVR was below grade 1 in 37 of the 44 survivors who were not reoperated upon. Mitral function was satisfactory after Carpentier valvuloplasty, with a mean transmitral gradient of 3.3 +/- 1.3 mmHg and a mean mitral valve area of 2.9 +/- 0.98 cm2. In 3 patients an intraventricular gradient of 10 to 20 mmHg, reflecting moderate ventricular obstruction, was detected by Doppler velocimetry. These data obtained with the combined Doppler-echocardiographic method confirm that the quality of mitral function is excellent after Carpentier mitral valvuloplasty.