The role of echocardiography in the selection of mitral valve prosthesis

Assessment of the left ventricular outflow tract was made echographically in 70 patients who subsequently received a mitral prosthesis. Group A (44 patients) had normal left ventricular outflow tract width (greater than 20 mm.); 13 received the Starr-Edwards prosthesis and nine received the Braunwald-Cutter prosthesis. There were two patients with low cardiac output syndrome and no hospital deaths. Group B (26 patients) had a narrow left ventricular outflow tract (less than 20 mm.). Thirteen patients received the Starr-Edwards prosthesis. One patient had low cardiac output syndrome, and there were no hospital deaths. We conclude that the use of the ball-and-cage prosthesis in the mitral position in patients with a narrowed left ventricular outflow tract (less than 20 mm.) measured echographically is not associated with an increased surgical risk.