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Percutaneous Mitral Valvulotomy

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Intraprocedural Imaging of Cardiovascular Interventions

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Abstract

Rheumatic mitral stenosis remains a common mitral valve disorder in the developing world. Percutaneous Mitral Valvotomy is an important therapy for rheumatic mitral stenosis. This chapter will review the critical role that echocardiography plays in the diagnosis, assessment of suitability and guidance of percutaneous mitral valvotomy.

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Author information

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Blake 256, Boston, MA, 02114-2696, USA

    Judy W. Hung MD & Yong Hyun Park MD

Authors
  1. Judy W. Hung MD
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  2. Yong Hyun Park MD
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Corresponding author

Correspondence to Judy W. Hung MD .

Editor information

Editors and Affiliations

  1. Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

    Michael H. Picard

  2. Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

    Jonathan J. Passeri

  3. Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA

    Jacob P. Dal-Bianco

Electronic Supplementary Material

Video 3.1

Parasternal long axis view of patient with low Wilkins Echo Score for rheumatic mitral stenosis. Anterior leaflet is highly mobile with doming occurring only at the tips. The leaflets have minimal thickening and calcification. Subvalvular region is often not well seen in the parasternal long axis view but appears only mildly involved. Overall Wilkins Echo Score is 5 (Mobility =1; Thickening =1; calcification=1; Subvlavular = 2) (AVI 2339 kb)

Video 3.2

Apical 4 chamber view of same patient in supplemental video1 with low Wilkins Echo Score for rheumatic mitral stenosis. Anterior leaflet is highly mobile without evidence of doming. The leaflets have minimal thickening and calcification. Subvalvular region is better seen in the apical 4 chamber view compared to the parasternal long axis and shows mild involvement. (Mobility =1; Thickening =1; calcification=1; Subvlavular = 2) (AVI 3043 kb)

Video 3.3

Parasternal long axis view of patient with high Wilkins Echo Score for rheumatic mitral stenosis. Entire anterior leaflet is poorly mobile and there is diffuse thickening and calcification of leaflets. Subvalvular thickening involves the distal third of the chords. Overall Wilkins Echo Score is 13 (Mobility =4; Thickening =3; calcification=3; Subvlavular = 3) (AVI 6207 kb)

Video 3.4

Apical 4 chamber view of corresponding patient in vidso 3 with high Wilkins Echo Score for rheumatic mitral stenosis. Entire anterior leaflet is poorly mobile and there is diffuse thickening and calcification of leaflets. Subvalvular thickening involves the distal third of the chords. Overall Wilkins Echo Score is 13 (Mobility =4; Thickening =3; calcification=3; Subvlavular = 3). (AVI 6313 kb)

Video 3.5

Transesophageal echocardiogram showing a mobile echodensity in left atrial appendage consistent with thrombus (AVI 3998 kb)

Video 3.6

3DTransesophageal echocardiogram showing left atrium as viewed from superior aspect. Patient is s/p trans septal puncture (transseptal sheath can be seen acrossing the interatrial septum into the left atrium) (AVI 737 kb)

Video 3.7

Transesophageal echocardiogram showing inflation of Inoue balloon across mitral valve during percutaneous mitral valvuloplasty (AVI 3257 kb)

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© 2016 Springer International Publishing Switzerland

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Hung, J.W., Park, Y.H. (2016). Percutaneous Mitral Valvulotomy. In: Picard, M., Passeri, J., Dal-Bianco, J. (eds) Intraprocedural Imaging of Cardiovascular Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-29428-5_3

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  • DOI: https://doi.org/10.1007/978-3-319-29428-5_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29426-1

  • Online ISBN: 978-3-319-29428-5

  • eBook Packages: MedicineMedicine (R0)

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