By Milind Desai, Christine Jellis, Teerapat Yingchoncharoen
Valvular middle medication revolves round the have to effectively determine destinations of pathological buildings and/or the interventional instruments had to deal with that pathology. The imaging of the valves is constructing at a huge speed and the clinician needs to be conscious of the benefits of each one modality and the way it compares to the others to be had. there's a want for a pragmatic, scientific atlas designed to paintings the reader via instances and assessing the superior offerings on hand to physicians. This atlas will symbolize the complete multimodality imaging judgements wanted while assessing mitral valvular problems. inside of this atlas the authors should be featuring a entire pictorial review of the hugely complicated pathology/treatment options and administration during this assorted workforce of sufferers with various mitral valvular pathologies. Imaging modalities flow speedy representing problem to practitioners. This atlas will permit them to profit the alternatives on hand and be good versed in recommendations. it is going to as a result be crucial analyzing for all cardiac imagers, surgeons, interventionalists, anesthetists and trainees in those disciplines.
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Extra resources for An Atlas of Mitral Valve Imaging
The formula for calculation of MVA is As described for the assessment of mitral regurgitation, it is possible to calculate the blood flow across a stenotic or regurgitant orifice based on the hemispheric shape of the convergence zone of mitral flow formed during diastole on the LA side. In mitral stenosis, the PISA formula must be adjusted for the angle formed by the leaflets (π/180°), yielding this formula: ( ) MVA = p D2 / 4 ( VTI aorta / VTI mitral ) where D is the LVOT diameter and VTI is the velocity time integral in centimeters.
The influence of image plane variations on MVA measurements is more pronounced if the mitral valve morphology is prominent doming rather than funnel shape . 11), which provides better alignment of the image plane at the mitral tips [3–5]. 2 Assessment of Mitral Valve Function Fig. 10 3D transesophageal echo image of a stenotic mitral valve 25 26 Fig. 11 3D reconstruction of a stenotic mitral valve using QLAB quantification software (Philips, Amsterdam) C. Jellis and T. 2 Pressure Half-Time The PHT method relies on the fact that the rate of pressure decline in the left atrium during diastole is inversely proportional to the severity of mitral stenosis.
Yingchoncharoen 3 Calcific Degenerative Mitral Disease Fig. 2 T. Yingchoncharoen Case 2. Calciﬁc Mitral Stenosis A 55-year-old man with end-stage renal failure secondary to Alport’s disease who is undergoing thrice-weekly hemodialysis reports increasing breathlessness with minimal exertion and palpitations. He was noted to have a murmur on auscultation (Figs. 14). 7 3D reconstruction of the mitral valve in short axis, demonstrating heavy leaflet and annular calcification, which restricts leaflet opening Fig.