intraoperatie MR

Am J Cardiol. 2000 Jan 15;85(2):199-203.

Effect of general anesthesia on the severity of mitral regurgitation by
transesophageal echocardiography.

Grewal KS, Malkowski MJ, Piracha AR, Astbury JC, Kramer CM, Dianzumba S, Reichek
N.

Department of Anesthesia, Allegheny General Hospital, Pittsburgh, Pennsylvania,
USA.

The effect of general anesthesia on the severity of mitral regurgitation (MR) was
examined in 43 patients with moderate or severe MR who underwent preoperative and
intraoperative transesophageal echocardiography. Systolic blood pressure, mean
arterial pressure, and left ventricular end-diastolic and end-systolic dimensions
were significantly lower during the intraoperative study, reflecting altered
loading conditions. The mean color Doppler jet area and mean vena contracta
decreased and the mean pulmonary venous flow pattern changed from reversed to
blunted, reflecting a significant reduction in the severity of MR. Overall, 22 of
the 43 patients (51%) improved at least 1 MR severity grade when assessed under
general anesthesia. Thus, intraoperative transesophageal echocardiography may
significantly underestimate the severity of MR. A thorough preoperative
assessment is preferable when deciding whether to perform mitral valve surgery.