Escolar Documentos
Profissional Documentos
Cultura Documentos
Duran Classification
Ann Thorac Surg 1998: 65:1025-1031. J Heart Valve Dis 1995; 4:70-75. Cardiol Clin. 2000; 18: 731-50.
Mid-esophageal 4C View
A3 and A1
Commisural View
P3-A2-P1
Mid-esophageal Views
(Transducer @ 0)
Mid-esophageal Views
(Transducer @ ~60)
Commissural View
Commissural View
Flail medial scallop
Transgastric Views
(Transducer @ 0)
n
6
45
TEE diagnosis
6
45
Accuracy (%)
100 100 33
52 Total 54
96
JASE.1998;11:966-71.
Accuracy of Transesophageal Echocardiographic Diagnosis of Affected Scallop Among Patients With Posterior Flail Mitral Leaflet
Affected Scallop Identified
Middle (P2)
Lateral (P1) Medial (P3)
n
34
7 10
82
89 100
Total
51
78
92
88
JASE.1998;11:966-71.
Diagnostic Accuracy of Identification of Mitral Regurgitant Defects by Correlation with Surgical Findings
Defect Location Sensitivity (%) Specificity (%)
A1 A2 A3 P1 P2 P3
n
45 28 5 5 4 3 6 3 54
Repaired (n)
30 20 5 3 1 1 0 2 32
Repaired (%)
67 71 100 60 25 33 0 67 59
JASE.1998;11:966-71.
Total
Pathologic Anatomic Changes to Assess During Transesophageal Echocardiographic Examination of the Mitral Valve Mitral Annulus
Calcification Dilatation Perivalvular Leak (Prosthetic Valves)
Circulation. 2000;101:695.
Mitral Leaflets
Billowing leaflet Coaptation level of anterior and posterior leaflet relative to annulus Systolic anterior motion of anterior leaflet Leaflet thickening Leaflet fusion (rheumatic); doming of fused leaflets in diastole (mitral stenosis) Calcification of leaflets Prolapse Deformation of leaflet free margin Thickening, retraction of free margin into ventricle (curling under) Endocarditis Vegetation, leaflet aneurysm, perforation, associated regurgitant jet of aortic insufficiency hugging ventricular side of anterior leaflet (possible source of infectious seeding)
Circulation. 2000;102:1400.
Circulation. 2000;102:1400.
Non-Classic MVP
Displacement > 2 mm
Chordae
Chordal systolic anterior motion Thickening Fusion Calcification Elongation Rupture
Papillary Muscles
Ruptured papillary muscle LV-papillary muscle dysfunction
Miscellaneous
Systolic anterior motion Mitral valve repair Narrow LVOT Small LV diameter Increased anterior and posterior leaflet area Miscellaneous Findings Left atrial enlargement Atrial appendage thrombus, LV dilation/aneurysm, TV annulus dilation, tricuspid regurgitation, right ventricular enlargement
Before
Am Heart J. 1996; 131: 162-76.
Before
Cardiol Clin. 1998; 16: 477-89.