[An echocardiographic evaluation of pure and isolated mitral stenosis. Comparisons with other noninvasive methods]

In 94/116 (81%) cases of pure and isolated mitral stenosis (MS), ECO-2D permitted the correct determination of the surface of the mitral opening (SMO). The cases were divided in terms of the SMO size into: extended MS (SMO greater than 2 cm2, n = 28), moderate MS (SMO between 1.1 and 2 cm2, n = 54), and narrow MS (SMO less than or equal to 1 cm2, n = 12). The SMO size influenced significantly the values of several noninvasive indices of the MS severity: the Wells index, the 2-C1DM noise interval, the NYHA class, the cardiothoracic index (expressed as an average, the +/- standard deviation for each group), and also the incidence of the atrial fibrillation, AQRS greater than or equal to 70 degrees, of the radiographic aspect of the pulmonary stasis or of the right cardiac failure (given in percent for each group). Anyhow, none of these parameters, taken alone, permitted the correct assessment of the MS severity. The sensibility, specificity and predictive value of the above-mentioned criteria were not sufficient for the detection of the narrow MS (SMO less than or equal to 1 cm2). ECO-2D is the most exact noninvasive method for appreciating the anatomical state of the mitral valvular apparatus in MS and for selecting the patients for the surgical correction.