Transesophageal Doppler color flow imaging in the detection of native and Bjork-Shiley mitral valve regurgitation

Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.

Regurgitant blood flow of mitral valves was studied by transesophageal Doppler color flow echocardiographic imaging in 11 healthy volunteers (Group 1), 25 cardiac patients with a native mitral valve (Group 2), 10 patients with a normally functioning Bjork-Shiley mitral prosthesis without clinical evidence of mitral regurgitation (Group 3) and 10 patients with angiographic or surgical evidence of Bjork-Shiley mitral valve regurgitation (Group 4). Holosystolic regurgitant color jets were classified as type I or type II. The data were compared with results obtained with precordial techniques, i.e., continuous wave and Doppler color flow echocardiographic imaging (Groups 1 to 4) and left ventricular angiography or surgery (Groups 2 and 4). In Group 1, transesophageal Doppler color flow imaging revealed no mitral regurgitant flow in 7 of the 11 patients and a type I jet in 4 patients that was detected in only 1 patient by precordial techniques. In Group 2, angiography showed no mitral regurgitation in 20 patients and documented mitral regurgitation in 5. Transesophageal Doppler color flow imaging detected in 4 of the 20 patients a type I jet that was not visualized with precordial techniques in 2 patients. Type II jets were detected by the transesophageal technique in all five patients with proven mitral regurgitation and were also visualized with precordial echocardiography. All patients in Group 3 showed two identical type I jets that were not detected with precordial echocardiography.(ABSTRACT TRUNCATED AT 250 WORDS)

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