[Clinical value of 2-dimensional echocardiography for quantifying mitral stenosis--possibilities and limits of the...

In 70 consecutive patients with the clinical diagnosis of mitral valve disease quantification of the mitral valve area was performed by 2-D echocardiography. In only 39 of these 70 patients (58%) could the mitral valve be satisfactorily positioned in the short-axis view for correct quantification of the valve area. In 31 patients a sufficient echo could not be assessed because of anatomical disorders, calcification of the valve or postoperative deformities of the valve apparatus after commissurotomy. In 30 of the 39 patients, in whom 2-D echocardiography allowed to determine the valve area, the results of the echocardiographic study corresponded with the valve area determined by angiography using the modified Gorlin formula. A sufficient correlation between both methods, however, was found only in patients with combined mitral valve disease (r = 0.81); no correlation could be found in the group of patients with pure mitral stenosis. From these results we conclude that in the individual patient 2-D echocardiography is not sufficient for exact quantification of mitral stenosis. Definite preoperative diagnosis necessitates additional investigations.