Subject(s)
Aortic Coarctation/diagnosis , Aged, 80 and over , Humans , Magnetic Resonance Imaging , Male , Recurrence , Treatment RefusalABSTRACT
AIM: Define echocardiographic predictors of the result after percutaneous mitral balloon commissurotomy (PMC). METHODS: PMC by the Inoue balloon was attempted in 247 patients (77% female) with severe mitral valve stenosis. The mean age was 35 years. All the patients had undergone echocardiographic examination before PMC to assess mitral anatomy, commissural calcification, and to determine the Wilkins score. RESULTS: The mean value of Wilkins score was 7,98 +/- 1,61 (range 5-13) and the mean mitral valve area (MVA) before PMC was 1 +/- 0,19 cm2 (range 0,5- 1,4 cm2). 29 patients (11,7%) had one-commissural calcification and 2 patients (0,8%) had bi-commissural calcifications. After PMC, the mean MVA increased to 1,79 +/- 0,34 cm2 (p <0,001) resulting in a success rate of 83%. Severe mitral regurgitation (> or =grade 3) occurred in five patients (2%). Wilkins score was an independent predictor of the immediate result of PMC but, if > 8, this score had a weak predictive value. Commissural morphology was another independent predictor of the immediate result of PMC. CONCLUSION: Echocardiography is now the cornerstone for the assessment of mitral anatomy before PMC and should integrate Wilkins score and commissural morphology for the selection of patients to PMC.
Subject(s)
Catheterization/methods , Echocardiography , Mitral Valve Stenosis/therapy , Mitral Valve/diagnostic imaging , Adolescent , Adult , Aged , Calcinosis/diagnostic imaging , Calcinosis/therapy , Catheterization/instrumentation , Child , Echocardiography, Transesophageal , Female , Forecasting , Humans , Male , Middle Aged , Mitral Valve Insufficiency/etiology , Mitral Valve Stenosis/diagnostic imaging , Postoperative Complications , Pulmonary Wedge Pressure/physiology , Treatment OutcomeABSTRACT
Do we bring back the observation of a patient aged of 42 years having a mitro-aortic valvulopathy who present since 3 months a level III dyspnea, a fever to 39 degrees C, a change of the general state and a splenomegaly. To the chest x-ray we note a pulmonary parenchymatous focus. Echocardiography puts in evidence a mitral illness to stenosis predominance and an aortic illness complicated of a graft bacterial with an abscess of the mitro-aortic trigone. Haemocultures were negative and the serology of the Rickettsia was positive. The diagnosis of infective endocarditis to Coxiella Burnetii is kept and is the patient put under Doxycycline 200 mg/j, Hydroxychloroquine 2 cp/j and Ofloxacine 400 mg/j. Will the two first antibiotics be pursued to the 18th month. The patient benefited, after 20 days of three antibiotics therapy, of a duplicate aortic and mitral replacement with simple following.
