scholarly journals Mitral Valve Vena Contracta Area

2020 ◽  
Author(s):  
Keyword(s):  
Mitral Valve ◽  
Vena Contracta ◽  
Vena Contracta Area

scholarly journals Prognostic value of three dimensional-vena contracta area in patients with secondary mitral regurgitation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
I Yedidya ◽  
V Mantegazza ◽  
F Namazi ◽  
R Lustosa ◽  
S C Butcher ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Color Doppler ◽  
Three Dimensional ◽  
Heart Failure Hospitalization ◽  
Vena Contracta ◽  
All Cause Mortality ◽  
3D Color Doppler ◽  
Vena Contracta Area

Abstract Background Effective regurgitant orifice area (EROA) is an important quantitative measurement for mitral regurgitation (MR) grading. Yet, the accuracy of this method is limited in patients with secondary mitral regurgitation (SMR). Three-dimensional (3D) color Doppler echocardiography allows for the direct assessment of the vena contracta area (VCA). The prognostic value of 3D-VCA in patients with secondary MR has not been investigated. Purpose The aim of the present study was to assess the association between 3D-VCA and prognosis of patients with SMR. Methods A total of 218 patients (69% men, median age 74 years) with significant SMR were retrospectively analyzed. 3D-VCA was measured offline with dedicated software, from restored 3D color Doppler full volume datasets of the mitral valve (Figure 1). The population was divided according to the American College of Cardiology expert recommendation for the grading of severe MR (VCA ≥50 mm2 and VCA <50 mm2). Patients were followed up for the combined end point of all-cause mortality or heart failure hospitalization. Results Of the total population, 63% had an ischemic etiology, 60% had atrial fibrillation and 25% cardiac resynchronization therapy. Patients with 3D-VCA ≥50 mm2 needed more diuretic therapy, had a larger left ventricle and atrium, and had more post-procedural residual MR. A total of 82% of patients underwent MitraClip device implantation, 17% had mitral valve repair and 1% had mitral valve replacement. During a median follow-up of 28 months, 130 (60%) met the combined end point (101 (46%) patients died and 81 (37%) were hospitalized due to heart failure). When dividing the population according to the cut-off of 3D-VCA, patients with a 3D-VCA≥50 mm2 had a worse prognosis compared with their counterparts (Figure 2). In a multivariable Cox regression analysis, 3D-VCA≥50 mm2 remained independently associated with the composite endpoint of all-cause mortality or heart failure hospitalization (HR=1.454, 95% CI 1.020–2.072, p=0.038). Conclusion In patients with SMR, a 3D-VCA ≥50 mm2 was independently associated with a combined endpoint of death or heart failure hospitalization. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. Method of 3D-VCA measurement Figure 2. Kaplan-Meier survival curve

scholarly journals Impact of the implantation of one MitraClip on the mitral valve anatomy: NTR vs. XTR

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Kassar
Keyword(s):  
Mitral Valve ◽  
Vena Contracta ◽  
Funding Sources ◽  
Mitral Repair ◽  
Before And After ◽  
Vena Contracta Area ◽  
The Impact ◽  
Device Size ◽  
Valve Area ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Percutaneous mitral repair using MitraClips (MC) for severe symptomatic regurgitation (MR) has emerge as an alternative treatment for selected high risk surgical patients. Despite the high number of cases treated with both iterations of the MC, the small NTR and the big XTR, the impact of the device size on the mitral valve area (MVA), the morphology of the annulus, the severity of the MR and the use of multiple device is still unknown. Methods High quality volume focused on the MV were acquired during each intervention. Using a dedicated 3-D analysis software the dimensions of the annulus, the MVA and the 3-D vena contracta area (VCA) were evaluated before and after clipping. After implantation, the area of both orifices were measured independently and summed. Results A total of 120 patients were included, 63 received a NTR and 57 a XTR. Before clipping, XTR cases had bigger MVA (5.9+/-1.7 vs. 4.9+/-1.3 cm2, p .001), a trend toward bigger VCA (0.56+/-0.7 vs. 0.51+/-0.9 cm2, p .073) and no difference in the anteroposterior (AP, 3.5 [3.1-4] vs. 3.5 [3.3-3.8] cm, p .47) and the lateromedial (LM, 4.2 [3.8-4.5] vs. 4.3 [4.0-4.5] cm) diameter of the annulus compared to NTR cases. One MC implantation produced a significant decrease of all these parameters but only MVA was significantly more reduce by XTR (Figure 1). The patients receiving a NTR as first MC did not need more often a second clip (31/63 vs. 26/57, p .072). Conclusions On average, both devices produce a MVA reduction of more than 50% and an indirect annuloplasty mainly in the anteroposterior direction. The use of an XTR as first MC do not decrease the probability of the necessity of a second one. All these parameters should be carefully taken into account when defining the implantation strategy. Abstract Figure.

Quantification of Tricuspid Regurgitation by Live Three-Dimensional Transthoracic Echocardiographic Measurements of Vena Contracta Area

2006 ◽  
Vol 23 (9) ◽  
pp. 793-800 ◽  
Author(s):  
Dasan E. Velayudhan ◽  
Todd M. Brown ◽  
Navin C. Nanda ◽  
Vinod Patel ◽  
Andrew P. Miller ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Three Dimensional ◽  
Vena Contracta ◽  
Vena Contracta Area

1051 Assessment of asymptomatic severe aortic regurgitation by doppler-derived echo indices: comparison with magnetic resonance quantification

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
Z Hlubocka ◽  
H Linkova ◽  
A Praveckova ◽  
A Polednova ◽  
G Dostalova ◽  
...  
Keyword(s):  
Volumetric Method ◽  
Flow Reversal ◽  
Descending Aorta ◽  
Vena Contracta ◽  
Severe Aortic Regurgitation ◽  
Diastolic Flow ◽  
Asymptomatic Patients ◽  
Doppler Indices ◽  
And Function ◽  
Vena Contracta Area

Abstract Funding Acknowledgements This study was supported by Ministry of Health of the Czech Republic 17-28265A Introduction Management of asymptomatic patients with chronic severe aortic regurgitation (AR) is challenging. Reliable quantification of the AR severity is essential. Transthoracic echocardiography (TTE) is a primary imaging modality. Grading of AR severity is achieved by an integrative approach. Cardiovascular magnetic resonance (CMR) can directly quantify AR severity by measuring regurgitation volume (RV) and regurgitation fraction (RF). Purpose There are few data on direct comparison between TTE and CMR for quantification of AR. Our study aimed to compare quantitative and indirect echo-Doppler indices to quantitative MRI derived parameters in asymptomatic patients with severe chronic AR. Methods In a prospective three-centre study, we evaluated patients with moderate to severe (3+) and severe (4+) chronic AR using TTE and CMR. All patients were asymptomatic, without indication for surgical treatment. The severity of AR was graded using TTE multiparametric approach. A 2-D and 3-D TTE were performed with an assessment of left ventricle size and function, valve morphology, Doppler parameters of AR including vena contracta width, diastolic flow reversal velocity in descending aorta, RV, RF using volumetric method, 3D-vena contracta area (3D-VCA). The CMR quantified left ventricle volumes and function, RF and RV using the phase-contrast velocity mapping. All imaging studies were analysed in CoreLab. Results A total of 104 patients were enrolled during 2015-2018. Mean patient age was 44 ± 13 years, 89 patients (86%) were males and 83 patients (81%) had a bicuspid or unicuspid aortic valve. Using the TTE severe (4+) AR was present in 48 (46%) and moderate to severe (3+) AR in 56 (54%) individuals. Concordant grading of AR severity with both techniques was observed in 77 (74%) patients. An integrative TTE approach showed a trend to underestimate AR severity. The best correlation between echo-Doppler indices and CMR measured RV and RF was found in two parameters: diastolic flow reversal velocity in descending aorta ( Rs = 0,62, p < 0,0001 for RV, Rs = 0,50, p < 0,0001 for RF) and 3D-VCA (Rs = 0,48 for RV, p < 0,0001 , Rs = 0,38 for RF, p < 0,0001). On the contrary vena contracta width showed poor correlation with CMR (Rs = 0,18, p = 0,07 for RV and Rs = 0,11, p = 0,29 for RF). Correlation between quantitative parameters of AR assessed by TTE volumetric method and CMR technique was modest (Rs = 0,40 for RF and Rs = 0,50 for RV, p < 0,0001), 95% confidence intervals were wide. Good correlation between TTE and CMR were found for LV dimensions, volumes and ejection fraction. Conclusion Out of indirect Doppler-echo indices of AR severity, diastolic flow reversal velocity in descending aorta and 3D-vena contracta area showed the best correlation with MRI derived RF and RV in patients with chronic severe AR. Quantitative parameters of AR (RF and RV) assessed by echo volumetric method had an only modest correlation to RF and RV measured using CMR.

Application of the Vena contracta Method for the Calculation of the Mitral Valve Area in Mitral Stenosis

Cardiology ◽  
2002 ◽  
Vol 98 (1-2) ◽  
pp. 50-59 ◽  
Author(s):  
Adnan Abacı ◽  
Abdurrahman Oguzhan ◽  
Şükrü Ünal ◽  
Burhanettin Kıranatlı ◽  
Namık Kemal Eryol ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Stenosis ◽  
Vena Contracta ◽  
Mitral Valve Area ◽  
Valve Area
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