Twenty-seven patients with moderate or severe mitral stenosis (MS) were studied by cardiac catheterization and angiography, 2-dimensional (2-D) echocardiography and Doppler echocardiography to assess the ability of Doppler ultrasound to accurately measure mitral valve orifice area and to assess whether mitral regurgitation (MR) affected the calculation. Mitral valve area by Doppler was determined by the pressure half time method. There were good correlation between 2-D & Doppler echocardiography (r=0.84) and between cardiac catheterization & Doppler echocardiography (r=0.83) regardless of the presence of MR. It is concluded that the Doppler echocardiography provides a simple, accurate, useful noninvasive method for the estimation of mitral valve area in patients with MS even in the presence of complicating MR.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Doppler ; Humans ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis* ; Ultrasonography*

Two-dimensional and Doppler echocardiographic examination were obtained in 31 patients both immediately and 2 to 5 months(mean3.1+/-1.8) after balloon dilation. Mitral valve area by planimetry immediately after valvuloplasty measured 1.8+/-0.3cm2 and 1.7+/-0.3cm2 at 2-5 months follow-up, but the difference was satistically insignificant. More than 15% decrease of the mitral valve area at follow-up was noticed in 10 patients(32%), but the valve area at follow-up was >1.5cm2 in all patients. Left atrial size(antero-posterior diameter) and volume by 2-dimensional echocardiography decreased more remarkably from 4.4+/-0.7cm, 82+/-42cm3 immediatly after vavuloplasty to 4.2+/-0.7cm, 68+/-26cm2 at follow-up respectively but there was no statistical significance. Mitral regurgitation graded by pulsed Doppler ultrasound decreased from 1.6+/-0.7 immediatly after valvuloplasty to 1.3+/-0.5(p<0.09) at follow-up, but there was no significant change in peak E velocity, EF slope, fractional shortening and ejection fraction. Symptomatic improvement at follow-up occured in all but one patient. Thus, 2 to 5 months after balloon mitral valvuloplasty there was no significantly after valvuloplasty decreased slightly at follow-up.
Echocardiography* ; Follow-Up Studies* ; Humans ; Mitral Valve Insufficiency ; Mitral Valve* ; Ultrasonography

Introducing some advantages of cardiac ultrasound (through chest wall and trans-esophagus) in diagnosis of mitral stenosis. In Vietnam, Some kinds of cardiac ultrasound were applied since 1973 including M-mode ultrasound, 2D ultrasound, Doppler, and color ultrasound. Internal treatment and surgical treatment (including in closed or opened cardiac surgery, percutaneous mitral balloon valvotomy) are very efficient
Mitral Valve Stenosis ; ultrasonography ; Heart Diseases ; diagnosis ; Therapeutics

98 patients were operated surgical commissurotomy in the No 108 Military Hospital from March 1995 to May 2000. All patients were performed Doppler ultrasonography pre- and post-operation. All patients were received surgical commissurotomy by Tubs. Hemodynamics was changed with satisfactory results after surgical commissurotomy the pulmonary arteries pressure down from 50.4  15.5 to 36.6  7.9 mmHg; MaxPG (mmHg) down from 22.1  7.6 to 12.3  3.3 and mean PG (mmHg) also down from 13.5  4.8 to 6.9  4.5. For right indication and contraindication in surgical intervention, as well as prognosis of postoperative patient's life, the evaluation of hemodynamic indexes are necessary, in which Doppler ultrasound plays an importance role in assessing the pre- and postoperative results
Hemodynamics ; Pulmonary Artery ; heart ; Mitral Valve ; surgery ; Ultrasonography

We report here on a case of double-orifice mitral valve with mitral regurgitation in a 75-year-old female who had complaints of mild dyspnea. Transthoracic and transesophageal echocardiography showed two orifices that were supplied by their own chordae from a different papillary muscle. Color Doppler echocardiography revealed moderate to severe mitral regurgitation due to the flail posterior leaflet of the anterolateral orifice. Except for the persistent left superior vena cava, no other congenital anomaly was demonstrated. The patient became asymptomatic with the administration of angiotensin-converting enzyme inhibitor and diuretics, and she has been scheduled for long term follow-up.
Papillary Muscles/abnormalities/ultrasonography ; Mitral Valve Insufficiency/*etiology/ultrasonography ; Mitral Valve/*abnormalities/ultrasonography ; Humans ; Female ; Echocardiography, Doppler, Color ; Chordae Tendineae/abnormalities/ultrasonography ; Aged

BACKGROUND: Spontaneous echo contrast (SEC) of the left atrium (LA) is associated with increased risk of thromboembolism in patients with mitral stenosis(MS). The determination of the presence and severity of LA spontaneous echo contrast(SEC) is of prognostic importance in these patients. Harmonic imaging(HI), a novel echocardiographic technique that differs from conventional fundamental imaging(FI) by transmitting ultrasound at one frequency and receiving at twice the transmitted frequency, produces better endocardial border definition and myocardial opacification. However, there are no data about its value on the detection of LA SEC. The purpose of this study was to investigate the utility of transthoracic noncontrast HI in the detection of LA SEC in patients with. METHODS: Seventy-four consecutive patients with MS (49 female, mean age 51) underwent standard transthoracic echocardiograms (TTE) in both HI and FI and transesophageal echocardiography (TEE) to determine the presence and severity of LA SEC. LA SEC was graded by TEE; mild if only seen at high gain, severe if visible in the entire LA at normal gain control of the equipment. Control subjects comprised of 30 patients randomly selected from patients who did not have LA SEC at TEE examination. RESULTS: Atrial fibrillation was found in 46 patients (62.2%). The mean mitral valve area and mean mitral gradient were 1.0+/-0.3cm2 and 8.2+/-4.1mmHg, respectively. Nine patients (12.2%) had episodes of systemic embolism; stroke in 8 and peripheral embolism in 1. LA thrombus was found in 11 patients (14.9%) by TEE. LA SEC was present in all but one patient by TEE (mild in 35, severe in 38 patients). FI of TTE, however, revealed LA SEC in only 5 (6.8%) of the 73 patients. In contrast, in HI, LA SEC could be detected in 63 (86.3%) of the 73 patients. In the detection of severe LA SEC, the sensitivity of FI and HI were 13.2% (5/38) and 100% (38/38), respectively. LA SEC was not observed in control subjects either by FI or HI. CONCLUSION: Transthoracic HI significantly enhances the detection of LA SEC in patients with MS.
Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography

This study evaluated pulsed TDI variables including the isovolumic time interval and duration of the major wave in a population of large healthy dogs. Longitudinal myocardial motion at the septal mitral annulus was evaluated with pulsed TDI in 45 healthy adult dogs. Maximal myocardial velocities, isovolumic time intervals, and duration of the myocardial waves were measured. The correlation between time intervals and velocity variables was also investigated. The mean maximal systolic velocity was 6.92 +/- 1.78 cm/sec, the mean early diastolic velocity (Em) was 6.58 +/- 1.81 cm/sec, the mean late diastolic velocity (Am) was 5.10 +/- 2.00 cm/sec, the mean isovolumic contraction time (IVCT) was 53.61 +/- 95.13 msec, and the mean isovolumic relaxation time (IVRT) was 26.74 +/- 57.24 msec. The early diastolic mitral inflow velocity (E)/Em ratio was 10.94 +/- 3.27 while the Em/Am ratio was 1.40 +/- 0.40. There was a negative correlation between Am duration and Am amplitude, and a positive correlation between the IVRT and Em/Am ratio (p < 0.05). The normal LV parameter using pulsed TDI method could be used as the reference range for identifying myocardial dysfunction in dogs.
Animals ; Dogs/*anatomy & histology ; Female ; Heart Ventricles/*ultrasonography ; Male ; Mitral Valve/*ultrasonography ; Ultrasonography, Doppler, Pulsed/methods/*veterinary

This study was conducted to explore the geometrical changes of the mitral annulus during systole. The 3D shape of the mitral annulus was reconstructed in 13 normal subjects who had normal structure of the mitral apparatus using real-time 3D echocardiography (RT3DE) and 3D computer software. The two orthogonal (antero-posterior and commissure-commissure) dimensions, the areas (2D projected and 3D surface) and the non-planarity of the mitral annulus were estimated during early, mid and late systole. We demonstrated that the MA had a "saddle shape" appearance and it consistently enlarged mainly in the antero-posterior direction from early to late systole with lessening of its non-planarity, as was determined by 3D reconstruction using RT3DE and 3D computer software.
*Echocardiography, Three-Dimensional ; Humans ; Image Processing, Computer-Assisted ; Mitral Valve/cytology/*ultrasonography ; Software ; Systole/*physiology

BACKGROUND: There have been a number of studies on mitral valve replacement and repeated percutaneous mitral balloon valvotomy for mitral valve restenosis after percutaneous mitral balloon valvotomy. However, studies on mitral valve repair for these patients are rare. In this study, we analyzed postoperative outcomes of mitral valve repair for mitral valve restenosis after percutaneous mitral balloon valvotomy. METHODS: In this study, we assessed 15 patients (mean age, 47.7+/-9.7 years; 11 female and 4 male) who underwent mitral valve repair between August 2008 and March 2013 for symptomatic mitral valve restenosis after percutaneous mitral balloon valvotomy. The mean interval between the initial percutaneous mitral balloon valvotomy and the mitral valve repair was 13.5+/-7 years. The mean preoperative Wilkins score was 9.4+/-2.6. RESULTS: The mean mitral valve area obtained using planimetry increased from 1.16+/-0.16 cm2 to 1.62+/-0.34 cm2 (p=0.0001). The mean pressure half time obtained using Doppler ultrasound decreased from 202.4+/-58.6 ms to 152+/-50.2 ms (p=0.0001). The mean pressure gradient obtained using Doppler ultrasound decreased from 9.4+/-4.0 mmHg to 5.8+/-1.5 mmHg (p=0.0021). There were no early or late deaths. Thromboembolic events or infective endocarditis did not occur. Reoperations such as mitral valve repair or mitral valve replacement were not performed during the follow-up period (39+/-16 months). The 5-year event-free survival was 56.16% (95% confidence interval, 47.467-64.866). CONCLUSION: On the basis of these results, we could not conclude that mitral valve repair could be an alternative for patients with mitral valve restenosis after percutaneous balloon mitral valvotomy. However, some patients presented with results similar to those of mitral valve replacement. Further studies including more patients with long-term follow-up are necessary to determine the possibility of this application of mitral valve repair.
Balloon Valvuloplasty ; Disease-Free Survival ; Endocarditis ; Female ; Follow-Up Studies ; Humans ; Mitral Valve* ; Ultrasonography

Mitral valve disease is one of the most popular heart valve diseases. Precise positioning and displaying of the valve characteristics is necessary for the minimally invasive mitral valve repairing procedures. This paper presents a multi-resolution elastic registration method to compute the deformation functions constructed from cubic B-splines in three dimensional ultrasound images, in which the objective functional to be optimized was generated by maximum likelihood method based on the probabilistic distribution of the ultrasound speckle noise. The algorithm was then applied to register the mitral valve voxels. Numerical results proved the effectiveness of the algorithm.
Algorithms ; Heart Valve Diseases ; diagnostic imaging ; Humans ; Likelihood Functions ; Mitral Valve ; diagnostic imaging ; pathology ; Patient Positioning ; Probability ; Ultrasonography