PRE-OPERATIVE INVESTIGATION OF 2D/3D ECHOCARDIOGRAPHIC CHARACTERIZATIONS AND MECHANISMS OF MITRAL VALVE REGURGITATION IN BACH MAI HOSPITAL

Thị Thu Hoài Nguyễn1,2,, Thị Dinh Tạ3
1 Bach Mai hospital
2 VNU - School of Medicine and Pharmacy
3 Bai Chay hospital

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Abstract

Background: Two-dimensional (2D) and three-dimensional (3D) transthoracic (TTE) and transesophageal echocardiography (TEE) are the main diagnostic modalities used to evaluate mitral valve disease. Aims: To investigate 2D/3D echocardiographic characterizations and mechanisms of mitral valve regurgitation in pre-operative patients in Bach Mai hospital. Method: A cross-sectional study was conducted at Vietnam National Heart Institute, BachMai hospital from September 2017 to June 2018. 44 patients with primary mitral regurgitation underwent 2D TEE and 2D/3D TEE. Among them, 29 patients had indication for before opened heart surgery. Results: Men/women ratio = 2/1. Mean age: 54.1 ± 13.1 years. Diameters of left atrium, left ventricle, right ventricle, mitral annulus were all larger than normal values. Mean vena contracta on 2D TTE was 0.69 ± 0,25 cm, on 2D TEE was 0.62 ± 0.21 cm. Mean EROA on 2D TTE was 0.65 ± 0.2 cm²,  on 2D TEE was 0.65 ± 0.2 cm². Mean vena contracta area on 3D TEE was 0.39 ± 0.11 cm2. Pre-operative patients had valve propalse, valve flail, hole on valve leaflet, vegetation, ruptured chordaes (anterior and posterior leaflet), restrictive pattern of mitral valve movement (due to rheumatic valvular disease). 3D TEE detected more vegetations (27.6%) and more ruptured chordaes of anterior leaflet (27.6%) compared to 2D TTE and 2D TEE. In 44 patients with primary mitral regurgitation, 41 patients (93.2%) had type II Carpentier MR and 3 patients (6.8%) had type IIIa Carpentier MR. Conclusion: Two-dimensional and three-dimensional transthoracic and transesophageal echocardiography are helpful in the evaluation of valvulopathies in pre-operative patients with primary mitral valve regurgitation.

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References

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