Journal of Cardiovascular Echography

ORIGINAL ARTICLE
Year
: 2019  |  Volume : 29  |  Issue : 1  |  Page : 7--13

StepWise protocols for scoring of mitral valve using three-dimensional transthoracic echocardiography in mitral stenosis


Ashraf M Anwar, Wael M Attia 
 Department of Cardiology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia; Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Ashraf M Anwar
Department of Cardiology, King Faahd Armed Forces Hospital, P. O. Box: 9862, Jeddah 21159

Aim: This study aims to propose protocols that enable scoring of mitral valve (MV) in mitral stenosis using the three-dimensional (3D) scoring system. Methods: A two-staged study was conducted. The first stage was designed to select the best 3D images of MV leaflets and chordae through analysis of 471 images. The second stage was designed to organize the best 3D images into protocols for complete scoring of MV. It included 35 consecutive patients; 23 had sinus rhythm (SR) and 12 had atrial fibrillation (AF). Both single- and multi-beat 3D acquisition from apical and parasternal windows were focused on MV leaflets and chordae using all 3D modalities (live, zoom, and full volume). To propose the protocols, 1563 images were analyzed. Results: In SR with good apical window, 2 protocols were recommended for complete scoring of leaflets and chordae (4 zoom 3D images [1 image for leaflets and 3 images for chordae] and 1 full-volume 3D image) using single- and multi-beat acquisition. In AF, the same 2 protocols using single-beat acquisition were recommended. From parasternal window, complete scoring of leaflets was obtained by 3 recommended protocols (single- or multi-beat zoom 3D images from parasternal short axis [PSAX], multibeat live 3D images from PSAX, and single- or multi-beat full-volume 3D images from parasternal long axis) in SR and 1 protocol in AF (single-beat zoom 3D images from PSAX). Scoring of chordae was incomplete in all patients by all 3D modalities. Conclusions: The proposed 3D-transthoracic echocardiography protocols suit all patients regardless of echo window and heart rhythm and enabled complete MV scoring.


How to cite this article:
Anwar AM, Attia WM. StepWise protocols for scoring of mitral valve using three-dimensional transthoracic echocardiography in mitral stenosis.J Cardiovasc Echography 2019;29:7-13


How to cite this URL:
Anwar AM, Attia WM. StepWise protocols for scoring of mitral valve using three-dimensional transthoracic echocardiography in mitral stenosis. J Cardiovasc Echography [serial online] 2019 [cited 2019 Sep 17 ];29:7-13
Available from: http://www.jcecho.org/article.asp?issn=2211-4122;year=2019;volume=29;issue=1;spage=7;epage=13;aulast=Anwar;type=0