Comparison of vena contracta width by multiplane transesophageal echocardiography with quantitative Doppler assessment of mitral regurgitation

Mitral regurgitation (MR) severity is routinely assessed by Doppler color flow mapping, which is subject to technical and hemodynamic variables, Vena contracta width may be less influenced by hemodynamic variables and has previously been shown to correlate with angio graphic estimates of MR severity, This study was performed to compare mitral vena contracta width by multiplane transesophageal echocardiography (TEE) with simultaneous quantitative Doppler echocardiography in 35 patients with MR, The vena contracta width was measured at the narrowest portion of the MR jet as it emerged through the coaptation of the leaflets it was identified in 97% of the patients, Vena contracta width regurgitant orifice area (R-2 = 0.81) by quantitative Doppler technique, A vena contracta width greater than or equal to 0.5 cm always predicted a regurgitant volume >60 mi and an effective regurgitant orifice area greater than or equal to 0.4 cm(2) in all patients, A vena contracta width less than or equal to 0.3 cm always pre dieted a regurgitant volume <45 mi and a regurgitant orifice area less than or equal to 0.35 cm(2). Thus, vena contracta width by multiplane TEE correlates well with mitral regurgitant volume and regurgitant orifice area by quantitative Doppler echocardiography and provides a simple method for the identification of patients with severe MR. (C) 1998 by Excerpta Medica, Inc.