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Mitral Stenosis Reversed by Medical Treatment for Heart Failure
Sawami Yukawa, RDCS, Masaaki Takeuchi, MD, Akemi Nakazono, RDCS, Kyoko Sakamoto, RDCS, Kiyoshi Araya, RDT, Masataka Eto, MD, Yosuke Nishimura, MD, Masaru Harada, MD, Robert A. Levine, MD, Yutaka Otsuji, MD The Annals of Thoracic Surgery Volume 96, Issue 5, Pages e115-e117 (November 2013) DOI: /j.athoracsur Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions
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Fig 1 (A) Mitral filling flow velocity by continuous wave Doppler echocardiography and mitral valve full opening at early diastole by apical long axis view 2 weeks after valve plasty for degenerative mitral regurgitation. The transmitral pressure gradient is only modestly increased with a peak and mean gradient of 9.7 and 4.4 mm Hg, respectively. The mitral leaflet opening is preserved (yellow arrow) and the mitral valve area (MVA) by continuity equation was 1.8 cm2. (B) At the time of the second heart failure that developed 4 years after surgery, the transmitral pressure gradient is significantly increased with a peak and mean gradient of 26.8 and 8.4 mm Hg, respectively. In association with left ventricular (LV) dilatation, the mitral leaflet opening is reduced (yellow arrow) with an MVA of 1.2 cm2, indicating significant functional mitral stenosis. (C) Four months after aggressive medical treatment for heart failure, the transmitral pressure gradient is significantly improved with a peak and mean gradient of 9.3 and 4.6 mm Hg, respectively. With reverse LV remodeling, the mitral leaflet opening is improved (yellow arrow) with an MVA of 1.7 cm2. (LA = left atrium.) The Annals of Thoracic Surgery , e115-e117DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions
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