Frequency and Predictors of Systemic Arterial Embolization in Rheumatic Mitral Valve Disease and Its Subgroups: Transesophageal Echocardiographic study

The aim of the study was to investigate the frequency and predictors of systemic arterial embolization (SAE) in patients (pts) with rheumatic mitral valve disease (RMVD) and in its subgroups (moderate to severe mitral stenosis- MS, severe mitral regurgitation-MR and mixed mitral valve disease). ı36 pts with predominant moderate to severe MS (mean age: 43± ll, 88 F, 75 w ith atrial fibrillation-AF and 88 pts with severe MR (mean age: 45±ı2, 6ı F, 42 with AF) and 83 pts with mixed mitral (mean age: 42±ı4, 55 F, 56 with AF) were included in the study. Transthoracic and transesophageal (TEE) echocardiography was performed in all pts. Left atrial (LA) diameter, mitral valve area, maximal and mean mitral gradients were measured and LA and LA appendage spontaneous echo contrast (SEC) - thrombus (THR) and MR were evaluated in all pts. Left atrial SEC was graded as mild, moderate and severe. Also history of all pts were evaluated in regard to SAE: it was classified as recent embolization when they occurred in the preceding :5: ı week and as remote embolization if they occurred > ı week before TEE. Multiple logistic regression analysis was used to determine independent predictors of SAE in all patients. Systemic arterial embolization was fonudin 11.7 % (36/307, 10 recent, 26 remote) of pts with RMVD. In the moderate to severe MS group (21.3 %, 29/ı36) frequency of SAE was significantly higher than that of the severe MR (3.4 % 3/88) and mİxed mitral (4.8 %, 4/83) group (pKeywords: Rheumatic mitral valve disease, systemic arterial embolization, transesophageal echocardiography