The objective of the work was a detailed examination of the incidence and changes of mitral regurgitation (MR) in conjunction with percutaneous transluminal valvotomy of the mitral valve (VMCH). Using coloured Doppler mapping, the authors examined a total of 40 patients before and in the course of one week after VMCH. They assessed the number of regurgitation jets the site of their development, the timing and haemodynamic impact of MR. Knowing the site of development of MR, the authors were able to assess whether the regurgitation after VMCH persisted, developed de novo or disappeared. The total number of mitral regurgitation increased after VMCH from 38 to 51 (increase by 34%, p < 0.05) with a significant rise of the number of double regurgitation jets (4 before as compared with 12 after VMCH, p < 0.05). Before VMCH the authors recorded a holocystic MR in 53%, after VMCH in 86% of the patients (p < 0.01). While before VMCH almost half the regurgitation jets originated in the central portion of the valve, after VMCH MR originated mainly from the area of commissures (48% regurgitation jets before, 79% after VMCH, p < 0.01). Only in 33% of MR after VMCH persisting regurgitation was involved, almost half (47%) of 38 regurgitation jets present before VMCH, disappeared after valvulotomy. MR displays a considerable variability. This may be one of the reasons why prediction of the development and severity of MR after PTMV is difficult.
Catheterization Echocardiography, Doppler