CAP 131 Flail mitral valve leaflet diagnosed by transesophageal echocardiography: Report of 35 cases
✍ Scribed by Marcia M Barbosa; Moˆnica Caldas; William AM Esteves; Lúcia MA Fenelon; Tamara Katina; Nilson Maia
- Publisher
- Elsevier Science
- Year
- 1997
- Tongue
- English
- Weight
- 156 KB
- Volume
- 23
- Category
- Article
- ISSN
- 0301-5629
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✦ Synopsis
Flail mitral valve leatlet may bc a serious condition and its accurate diagnosis and management are impnrtant. Tmnsesophageal echccardiography (TEE) is a sensitive technique to detect abnormalities of the mitral valve and its hemodynamic comprnmise. OBJlXTIVE:
To describe TEE findings and the evolution in patients presenting with flail mitraI valve @IblV). METHODOLOGY:
Analysis of the abnormalities deteckd by TEE in patients with FMV and the description of their clinical follow-up. RESULTS: From January 1993 to March 1997, 1675 TEES were performed at our institution. Among these, 35 (2%) had FMV. Mean age was 65 f 15 years ( (range 12 to 87) and 27 (77%) were male. All patients (pts) had ruptured cord except for one, in whom a redundant cord was present. Posterior leaflet was involved in 25 pts (71%). Etiology was prolapse an&or myxomatous degeneration in 15 (43%), degenerative in 9 (26%), ischemic in 5 (14%), rheumatic in 4 (11%) and endccarditis in 3 (9%). Vegetations were found in 3 and pexicardial effusion in 3. Mitral regurgitation was severe in 25 (71%) and moderate in 10 (29%) pts. Mean follow-up was 375 It 395 days and 16 pts had surgery (TEE diagnesis confumed in all). Among these, 3 died in hospital. Nineteen were followed clinically and 9 (47%) died. Both operated and non-operated pts who survived are in NYHA Class I (74%) and II (26%). CONCLUSION:
The diagnosis of FMV by TEE is accurate and allows adequate detinltion of its mechanism and he-c repercussion. The low NYHA Class observed in surviving pts may be due to the relatively short term follow-up of this study and does not necessarily mean a low morbidity of this condition.