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Ann Thorac Surg 1999;67:494-499
© 1999 The Society of Thoracic Surgeons
a Department of Cardiac Surgery, University of Heidelberg, Heidelberg, Germany
b Department of Medical and Biological Informatics, Deutsches Krebsforschungszentrum, Heidelberg, Germany
Accepted for publication September 12, 1998.
Address reprint requests to Dr De Simone, University of Heidelberg, Abteilung für Herzchirurgie, Im Neuenheimer Feld, 120 D-69120 Heidelberg, Germany
e-mail: r.de.simone{at}urz.uni-heidelberg.de
Background. Color Doppler echocardiography is a standard technique for assessing mitral regurgitation before and after mitral valvuloplasty. Mitral valve prolapse produces complex eccentric jet flows that cannot be visualized and measured by two-dimensional color Doppler echocardiography. The aim of this study was to evaluate the clinical impact of three-dimensional color Doppler echocardiography, a new technique developed at our institution, for assessing mitral regurgitation.
Methods. Forty-five patients with mitral regurgitation underwent intraoperative transesophageal echocardiography and three-dimensional Doppler data acquisition. The grade of mitral regurgitation was assessed by angiography. The jet areas were calculated by planimetry from conventional color Doppler; the jet volumes were obtained by three-dimensional Doppler data.
Results. New patterns of mitral regurgitant flows were recognized according to the origin, direction, and spatial spreading into the left atrium. Conventional jet areas failed to separate the groups of patients with different degrees of regurgitation, whereas the jet volumes were able to divide patients with different regurgitation grades. No significant correlation was found between jet area and angiographic grading (r = 0.63, p = NS). Jet volumes were significantly correlated to angiography (r = 0.89, p < 0.001).
Conclusions. Three-dimensional color Doppler echocardiography revealed new patterns of regurgitant flow and allowed a more accurate semiquantitative assessment of complex asymmetrical regurgitant jets.
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