LETTERS
References 1. Paris1 AF, TOW GE, Sasahara AI: Clinical appraisal of current nuclear and other noninvasive cardiac diagnostic techniques. Am J Cardiol 36: 722-730. 1976 2. liOrga JH, Kq VE, Holland WE, et al: Conelation of diagnostic echographic featwes of mitral stenosis with findings at calheterizatial and svgery In. Uftrasound in Medicine. Vol 2 (White D. Barnes F. ed). New York, Plenum Publishing. 1976. p 71
REPLY
FIGURE 1. Two dimensional cross-sectional and M mode views of a Stenotic mitral valve. A and C, diastolic cross-sectional views of the mitral orifice ma& with a phased array sects scanner. The radii (white lines) indicate the direction of a single beam for the M mode display. In C the radius is near the commissure rather than at the center of the slenotic wifice. Et. M mode record made along the beam directed Uvwgh the center of the mitral wifice as indicated in A; D, M mode accord from the radius shown in C. The E-F slope and valve excursion are less in D than in B.
leaflets when compared with cardiac catheterization data and measurements made at open commissurotomy. Echocardiographic categorization of mitral stenosis as severe (E-F slope 15 mm/set), moderate (15 to 25 mm/set) or mild (25 to 35 mm/set) was compared with estimates of the mitral valve area as calculated with the Gorlin formula and measured with calibrated probes at surgery: (severe CO.5 cm2, moderate 0.5 to 1.00 cm2 and mild 1.00 to 1.5 cm2). In 15 patients there was agreement between the echocardiographic and surgical estimate of the severity of mitral stenosis; in the remaining 11 patients the echocardiogram indicated greater stenosis than was found at surgery. Among the 21 patients whose valve area was calculated with the Gorlin formula, there was agreement in 6 between the echocardiographic and the Gorlin estimates of the severity of mitral stenosis; in 13 the echocardiogram indicated greater stenosis than the Gorlin formula, and in 2 the reverse was true. In the latter two patients the echocardiographic and surgical assessments of the severity of stenosis were in agreement. The presence of a low cardiac index, atria1 fibrillation and mitral regurgitation did not significantly contribute to these relations. Surgical assessment of impaired pliability was related to anterior mitral leaflet excursion of less than 20 mm and less than 15 mm. Ten of 14 patients considered to have impaired pliability at surgery had anterior leaflet excursions of less than 20 mm. One with pliable leaflets had an anterior leaflet excursion of less than 20 mm (P
References 1. Paris1 AF, TOW GE, Sasahara AI: Clinical appraisal of current nuclear and other noninvasive cardiac diagnostic techniques. Am J Cardiol 36: 722-730. 1976 2. liOrga JH, Kq VE, Holland WE, et al: Conelation of diagnostic echographic featwes of mitral stenosis with findings at calheterizatial and svgery In. Uftrasound in Medicine. Vol 2 (White D. Barnes F. ed). New York, Plenum Publishing. 1976. p 71
REPLY
FIGURE 1. Two dimensional cross-sectional and M mode views of a Stenotic mitral valve. A and C, diastolic cross-sectional views of the mitral orifice ma& with a phased array sects scanner. The radii (white lines) indicate the direction of a single beam for the M mode display. In C the radius is near the commissure rather than at the center of the slenotic wifice. Et. M mode record made along the beam directed Uvwgh the center of the mitral wifice as indicated in A; D, M mode accord from the radius shown in C. The E-F slope and valve excursion are less in D than in B.
leaflets when compared with cardiac catheterization data and measurements made at open commissurotomy. Echocardiographic categorization of mitral stenosis as severe (E-F slope 15 mm/set), moderate (15 to 25 mm/set) or mild (25 to 35 mm/set) was compared with estimates of the mitral valve area as calculated with the Gorlin formula and measured with calibrated probes at surgery: (severe CO.5 cm2, moderate 0.5 to 1.00 cm2 and mild 1.00 to 1.5 cm2). In 15 patients there was agreement between the echocardiographic and surgical estimate of the severity of mitral stenosis; in the remaining 11 patients the echocardiogram indicated greater stenosis than was found at surgery. Among the 21 patients whose valve area was calculated with the Gorlin formula, there was agreement in 6 between the echocardiographic and the Gorlin estimates of the severity of mitral stenosis; in 13 the echocardiogram indicated greater stenosis than the Gorlin formula, and in 2 the reverse was true. In the latter two patients the echocardiographic and surgical assessments of the severity of stenosis were in agreement. The presence of a low cardiac index, atria1 fibrillation and mitral regurgitation did not significantly contribute to these relations. Surgical assessment of impaired pliability was related to anterior mitral leaflet excursion of less than 20 mm and less than 15 mm. Ten of 14 patients considered to have impaired pliability at surgery had anterior leaflet excursions of less than 20 mm. One with pliable leaflets had an anterior leaflet excursion of less than 20 mm (P
