Impact of 3D transesophageal echocardiography assessment of mitral valve on short-term outcome of Balloon Mitral Valvuloplasty using additional quantitative parameters

Abstract

The goals of this prospective observational study were to identify quantitative morphological factors that might aid in the prediction of PBMV outcome, as well as to define the function of 3D TEE in mitral valve evaluation. Material and Methods: The trial comprised seventy individuals who had isolated severe rheumatic Mitral Stenosis (MS) who were scheduled for PBMV between October 2017 and March 2021. Trans-thoracic echocardiography (TTE) was used for pre-procedural evaluation. Posterior to Anterior Leaflet Length Ratio (P/ALLR), Commissural Area Ratio (CAR), Doming Height (DH), and Calcification Score (Ca score) were also assessed using 2D and 3D-Trans-esophageal Echocardiography (TEE). Following that, all patients were monitored for three months. Results: We have had 50(71.5%) successful procedures and 20(28.5%) unsuccessful procedures. The additional parameters showed highly significant difference between successful and un-successful groups (P-value <0.001). The cut-off points that predict successful procedures were; P/A LLR >0.6 and >0.55 by 2-D and 3-D TEE respectively, CAR ≤ 1.28 and ≤ 1.25 by 2-D and 3-D TEE respectively, DH > 1.2 cm by 2-D TEE, and Ca Score ≤ 2. Conclusion: In our research, we discovered that these characteristics may predict the result of PBMV and contribute value to the semi-quantitative methodologies we adopted to use.