Abstract
In 80 cases with mitral valvular defects, findings of ultrasonic echo cardiography were correlated with the operative findings, and tried to determine the echo cardiographic criterion useful in selecting the optimal surgical procedure. Valvular echo strength, chordal echo strength and modified amplitude (amplitude per unit body surface area) were found valuable in detecting valvular organic changes. The former two were graded into four groups. The valvular echo strength and valvular organic changes at operation agreed at 71%. The chordal echo strength and subvalvular organic changes at operation agreed at 60%. The mean values of modified amplitudes were 18.7 mm/M2 17.1 mm/M2 and 16.4 mm/M2 to slight, moderate and severe valvular organic changes at operation respectively. Normal value was 18.5 mm/M2. In mitral stenosis, 80% of the cases with poor commissurotomy results had grade 111 in valvular and/or chordal echo strength, and the remained 20% cases had grade II, with mean modified amplitude at 14.0 mm/M2. Cases of good commissurotomy results had grade 11 at 71% and grade I at 21%, with mean modified amplitude at 18.0 mm/M2. In mitral insufficiency group, annuloplasty cases were all in grade I or below with mean modified amplitude at 42.0 mm/M2, and valve replacement cases had grade 111 at 60% and grade 11 at 40% with mean modified amplitude at 22.4 mm/M2. Ultrasono-cardiographic criterion in selecting optimal operative procedure was discussed.
