Transesophageal Echocardiographic Evaluation of Pulmonary Venous Flow Patterns before and after Percutaneous Mitral Commissurotomy

Park, Seung Woo; Kim, Cheol Ho; Han, Kyoo Rok; Kim, Hyo Soo; Sohn, Dae Won; Oh, Byung Hee; Lee, Myoung Mook; Park, Young Bae; Choi, Yun Shik; Seo, Jung Don; Lee, Young Woo

Abstract

BACKGROUND
Pulmonary venous flow(PVF) is closely related to left atrial pressure(LAP) and percutaneous mitral commissurotomy(PMC) reduces LAP rapidly. However, PVF pattern in mitral stenosis(MS) with sinus rhythm after PMC remains to be elucidated.
METHODS
Transesophageal echocardiographic pulsed Doppler examination was performed within 24 hours before and after PMC to evaluate PVF pattern in 10 patients of MS with sinus rhythm.
RESULTS
Before PMC, both peak velocity(PV) and velocity time integral(VTI) during systole had significant negative correlations with mean LAP(r=-0.70, r=-0.79, respectively). After PMC, both systolic PV and VTI increased significantly without significant changes in diastolic PV and VTI. However, there was no significant correlation between systolic PV and mean LAP, and between systolic VTI and mean LAP after PMC.
CONCLUSION
In mitral stenosis with sinus rhythm, these data suggest that systolic PVF decreases with increase of mean LAP and PMC could reverse this change without affecting diastolic PVF. However, acute hemodynamic changes of left atrium induced by PMC may contribute to the absence of correlation between mean LAP and systolic PVF after PMC.