Vol 18, No 5 (2011)
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Published online: 2011-09-21
Continuity equation is the echocardiographic method of choice to assess degenerative mitral stenosis
Cardiol J 2011;18(5):577-580.
Abstract
We present a rare case of a patient with severe, symptomatic degenerative calcific mitral
stenosis (MS). Calcification of mitral valve annulus (MVA) is a frequent finding in elderly
patients. It can be isolated or associated more often with mitral valve insufficiency than MS. In
rare cases, it results in severe MS. An accurate measurement of MVA in degenerative calcific
MS is problematic because the limiting orifice is near the annulus and not at the leaflet tips as
in rheumatic MS. Continuity equation is the best echocardiographic method to assess the MVA
in degenerative MS, correlating well with invasive methods. Real-time three-dimensional
echocardiography is a promising tool and provides an accurate measurement of MVA in
calcific MS, with a very good correlation compared to continuity equation. On the other hand,
the use of pressure half-time is often inaccurate and should be avoided, while two-dimensional
planimetry is difficult and not reliable in degenerative MS. The values of mean gradient and
systolic pulmonary artery pressure depend on several factors and should be only supportive
signs and should not be considered as surrogate markers of the severity of MS.
(Cardiol J 2011; 18, 5: 577–580)
(Cardiol J 2011; 18, 5: 577–580)
Keywords: mitral stenosisechocardiographyDopplervalvular heart disease