A Systematic Proposal for the Use of Echo-Doppler in Patients Undergoing Mitral Ballon Valvuloplasty

pp 249-256

Abstract

Mitral balloon valvuloplasty has definitelly been incorporated to the treatment of mitral stenosis. Echocardiography, thanks to its abilty to define anatomic and hemodynamic changes in mitral rheumatic disease, is a useful ancillary technology to evaluate this kind of treatment. Nevertheless, there is no consensus about the timing and modality of its use, or the management of the obtained in-formation.The protocol here proposed is based on our own experience in the last 2 years and on the wide available bibliography. The main aim is to standardize the use of transthoracic and transesophageal echo-Doppler procedures (starting from the initial evaluation until the post-dilation follow-up) inpatients undergoing mitral balloon valvuloplasty, in order to avoid unnecessary discomfort, interference with the hemodynamic procedure and a common language to compare results among different medical centers. Transthoracic echocardiography in the cat-lab is carefully described. This approach was used in each of our cases. The management of the obtained in-formation, such as valvular score, presence of thrombi or mitral insufficiency, is also included in detail for each step, with a wide discussion of the current bibliography.