The Role of Intraoperative Transesophageal Echocardiography Guidance in Closed Mitral Commissurotomy [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1998; 26(2): 79-85

The Role of Intraoperative Transesophageal Echocardiography Guidance in Closed Mitral Commissurotomy

Muzaffer DEĞERTEKİN1, Yelda BAŞARAN1, Esat AKINCI1, Murat GENÇBAY1, Hüseyin YILMAZ1, İbrahim DURAN1, Fikret TURAN1, Cevat YAKUT1

patients with mitral stenosis, transesophageal echocardiography (TEE) can be used to preoperative evaluation of mitral valve morphology and left atrial thrombosis. In addition to preoperative applications, TEE can be utilized intraoperatively during percutaneous balloon mitral valvuloplasty (PBMV), open mitral commissurotomy and mitral valve replacement surgery. Percutaneous balloon mitral valvuloplasty is an effective but rather expensive method for the treatment of rheumatic mitral stenosis. Closed mitral commissurotomy (CMC) was a blind procedure before transesophageal echocardiography (TEE) era. We assesed the utility of TEE guidance during closed mitral commissurotomy to enhance the efficacy and reduce the complications of surgery. 27 patients (19F, 8 M), 16 of them pure mitral stenosis, 9 patients w ith mil d aortic insufficiency w ere included in the study. M ean age of study group w as 36.2±7 .4 years. ı 7 patients were in normal sinus rhythm and ı O were in atrial fibrillation. Mitral valve areas were (MV A) measured by pressure half time (PHT) and planimetic (PLN) methods before, during and after the CMC procedure by using transthoracic and transesophageal echocardiography. During surgery, insanı information was obtained by using Vingmed CFM 800 multiplane probe. The succes of the procedure was determined by following parameters: mitral valve excursion, mitral commissural leakage, MV A disappearence of spontaneous echocontrast and decrease of mitral valvular gradient, mitral regurgitation and rupture of the chordae. The MV As detected by PHT and PLN method s using TEE probe were significantly increased from 1.06±017 cm2 to 2.4±0.3 cmı and from 1.01±0.09 cm2 to 2.21±0.19 cmı, respectively after the CMC procedure (p<0.05 and p<0.05). Intraoperative TEE contributes to the surgeon's performance allowing to monitor the valve area and detect the potential complications, earlier.

Keywords: Transesophageal echocardiography, closed mitral commissurotomy, mitral stenosis.

How to cite this article
Muzaffer DEĞERTEKİN, Yelda BAŞARAN, Esat AKINCI, Murat GENÇBAY, Hüseyin YILMAZ, İbrahim DURAN, Fikret TURAN, Cevat YAKUT. The Role of Intraoperative Transesophageal Echocardiography Guidance in Closed Mitral Commissurotomy. Turk Kardiyol Dern Ars. 1998; 26(2): 79-85
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