Preoperative Assessment of Subvalvular Thickening by Transthoracic and Transesophageal Echocardiography in Patients Undergoing Valve Surgery in Rheumatic Mitral Valve Disease: Echocardiographic Characteristics Associated with Abascal Scoring

The purpose of this study is to evaluate and to compare the subvalvular thickening in patients with rheumatic mitral valve disease by Abaseat seering determined both by transthoracic and transesophageal echocardiography (TTE, TEE). Our study also aimed to investigate the quantitative basis of this semiquantitative scoring corresponding as transmitral gradient, valve area, chordal length, calcification and mitral regurgitation and to compare subvalvular thickening of patients who underwent mitral valve replacement and reconstruction. Study population comprised 364 patients with rheumatic mitral valve disease (F 241, M ı 23, mean age 4ı +22.6 yrs) subjected to preoperative TTE and TEE, 2 ı O and 154 of them underwent mitral va! ve replacement and mitral reconstruction, respectively. Abascal seering of subvalvular thickening of mitral valve and calcification were determined by TTE. Anterelateral and postemmedial chordal length (cm) was measured by TEE. Morphologic assessment for subvalvular thickening, by means of measurement of chordal length was also performed in excised mitral valves. Grade I, II, III and IV subvalvular thickening was detected in 177(48.6%), 107(29.4%), 65(17.8%) and 15 ( 4.1%) of patients by TTE. Mean transmitral gradient and mitral valve area were not found to be different (p>0.05) between grade I and II subvalvular thickening, but were significantly different between grade I and III (p<0.0004 and p=O.OOOI), grade II and III (p=0.02 and pKeywords: rheumatic mitral valve disease, subvalvular thickening, transesophageal echocardiography