Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty
Abstract Background Results of percutaneous balloon mitral valvuloplasty (BMV) are basically dependent on suitable patient selection. Currently used two-dimensional (2D) echocardiography (2DE) scores have many limitations. Three-dimensional (3D) echocardiography (3DE)-based scores were developed for...
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doaj-f1019d3a1ced4a1096081b910929355f2020-11-25T03:27:53ZengSpringerOpenThe Egyptian Heart Journal2090-911X2019-09-017111910.1186/s43044-019-0019-xAdditive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplastyHazem M. A. Farrag0Amr M. Setouhi1Mustafa O. El-Mokadem2Mustafa A. El-Swasany3Khalid S. Mahmoud4Hesham B. Mahmoud5Alaa M. Ibrahim6Cardiology Department, Faculty of Medicine, Minia UniversityCardiology Department, Faculty of Medicine, Minia UniversityCardiology Department, Faculty of Medicine, Beni-Suef UniversityCardiology Department, Faculty of Medicine, El-Azhar UniversityCardiology Department, Faculty of Medicine, Minia UniversityCardiology Department, Faculty of Medicine, Beni-Suef UniversityCardiology Department, Faculty of Medicine, Minia UniversityAbstract Background Results of percutaneous balloon mitral valvuloplasty (BMV) are basically dependent on suitable patient selection. Currently used two-dimensional (2D) echocardiography (2DE) scores have many limitations. Three-dimensional (3D) echocardiography (3DE)-based scores were developed for better patient selection and outcome prediction. We aimed to compare between 3D-Anwar and 2D-Wilkins scores in mitral assessment for BMV, and investigate the additive value of 3DE in prediction of immediate post-procedural outcome. Fifty patients with rheumatic mitral stenosis and candidates for BMV were included. Patients were subjected to 2D- and real-time 3D-transthoracic echocardiography (TTE) before and immediately after BMV for assessing MV area (MVA), 2D-Wilkins and 3D-Anwar score, commissural splitting, and mitral regurgitation (MR). Transesophageal echocardiography (TEE) was also undertaken immediately before and intra-procedural. Percutaneous BMV was performed by either multi-track or Inoue balloon technique. Results The 2DE underestimated post-procedural MVA than 3DE (p = 0.008). Patients with post-procedural suboptimal MVA or significant MR had higher 3D-Anwar score compared to 2D-Wilkins score (p = 0.008 and p = 0.03 respectively). The 3D-Anwar score showed a negative correlation with post-procedural MVA (r = − 0.48, p = 0.001). Receiver operating characteristic (ROC) curve analysis for both scores revealed superior prediction of suboptimal results by 3D-Anwar score (p < 0.0001). The 3DE showed better post-procedural posterior-commissural splitting than 2DE (p = 0.004). Results of both multi-track and Inoue balloon were comparable except for favorable posterior-commissural splitting by multi-track balloon (p = 0.04). Conclusion The 3DE gave valuable additive data before BMV that may predict immediate post-procedural outcome and suboptimal results.http://link.springer.com/article/10.1186/s43044-019-0019-xMitral stenosisPercutaneous balloon mitral valvuloplastyThree-dimensional echocardiographyMitral valve scoreMulti-track balloonInoue balloon |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hazem M. A. Farrag Amr M. Setouhi Mustafa O. El-Mokadem Mustafa A. El-Swasany Khalid S. Mahmoud Hesham B. Mahmoud Alaa M. Ibrahim |
spellingShingle |
Hazem M. A. Farrag Amr M. Setouhi Mustafa O. El-Mokadem Mustafa A. El-Swasany Khalid S. Mahmoud Hesham B. Mahmoud Alaa M. Ibrahim Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty The Egyptian Heart Journal Mitral stenosis Percutaneous balloon mitral valvuloplasty Three-dimensional echocardiography Mitral valve score Multi-track balloon Inoue balloon |
author_facet |
Hazem M. A. Farrag Amr M. Setouhi Mustafa O. El-Mokadem Mustafa A. El-Swasany Khalid S. Mahmoud Hesham B. Mahmoud Alaa M. Ibrahim |
author_sort |
Hazem M. A. Farrag |
title |
Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty |
title_short |
Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty |
title_full |
Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty |
title_fullStr |
Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty |
title_full_unstemmed |
Additive value of 3D-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty |
title_sort |
additive value of 3d-echo in prediction of immediate outcome after percutaneous balloon mitral valvuloplasty |
publisher |
SpringerOpen |
series |
The Egyptian Heart Journal |
issn |
2090-911X |
publishDate |
2019-09-01 |
description |
Abstract Background Results of percutaneous balloon mitral valvuloplasty (BMV) are basically dependent on suitable patient selection. Currently used two-dimensional (2D) echocardiography (2DE) scores have many limitations. Three-dimensional (3D) echocardiography (3DE)-based scores were developed for better patient selection and outcome prediction. We aimed to compare between 3D-Anwar and 2D-Wilkins scores in mitral assessment for BMV, and investigate the additive value of 3DE in prediction of immediate post-procedural outcome. Fifty patients with rheumatic mitral stenosis and candidates for BMV were included. Patients were subjected to 2D- and real-time 3D-transthoracic echocardiography (TTE) before and immediately after BMV for assessing MV area (MVA), 2D-Wilkins and 3D-Anwar score, commissural splitting, and mitral regurgitation (MR). Transesophageal echocardiography (TEE) was also undertaken immediately before and intra-procedural. Percutaneous BMV was performed by either multi-track or Inoue balloon technique. Results The 2DE underestimated post-procedural MVA than 3DE (p = 0.008). Patients with post-procedural suboptimal MVA or significant MR had higher 3D-Anwar score compared to 2D-Wilkins score (p = 0.008 and p = 0.03 respectively). The 3D-Anwar score showed a negative correlation with post-procedural MVA (r = − 0.48, p = 0.001). Receiver operating characteristic (ROC) curve analysis for both scores revealed superior prediction of suboptimal results by 3D-Anwar score (p < 0.0001). The 3DE showed better post-procedural posterior-commissural splitting than 2DE (p = 0.004). Results of both multi-track and Inoue balloon were comparable except for favorable posterior-commissural splitting by multi-track balloon (p = 0.04). Conclusion The 3DE gave valuable additive data before BMV that may predict immediate post-procedural outcome and suboptimal results. |
topic |
Mitral stenosis Percutaneous balloon mitral valvuloplasty Three-dimensional echocardiography Mitral valve score Multi-track balloon Inoue balloon |
url |
http://link.springer.com/article/10.1186/s43044-019-0019-x |
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