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Jan
27

Severity of Mitral Stenosis: Dr R Alagesan

2nd National Heart Valve Summit 2012

1.       M Mode: 2 D, Doppler, 3D criteria

2.       2D area in short axis, non calcific lesions is accurate, narrowest area, direct measurement, in AF 3-5 beats and average, 3D biplane or full volume data

3.       PG and MG, MG > 10 severe MS

4.       PHT > 220 msec, MVA is 1 cm 2

5.       Average of 3 beats in sinus rhythm and 5 beats in AF

6.       Heart rate should be 6—80n when measuring pressure half time

7.       When two slopes are present, use the mid late diastolic slope

8.       Continuity equation: AR will affect the area, AF not reliable

9.      PISAmethod can be used

10.   Exercise hemodynamic in borderline cases , increase in MG and PAP means severe MS

 

MR

11.   Jet area < 20% grade 1, 20-40%  grade 2, > 40% grade 3

12.   Eccentric jets look smaller

13.   Vena contracta, narrowest portion of MR jet, < 3mm mild, > 7 mm severe MR, multiple jets not useful

14.   PV flow, systolic reversal means severe MR

15.   E > 1.5 sever MR

16.   Asymmetric MR jet means severe MR

17.   RV and ERO are the tests of choice

18.   3D echo useful in diagnosing sever MR.

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