Assessing Mitral Valve Area: Planimetery vs. PHT (Pressure Half-Time) Methods

[deek]

Can anyone explain for me, if you will, the difference of assessing the Mitral Valve Area in Mitral Stenosis via the planimetry vs. the pressure half-time method and why there is such a variance between these two values? It's my understanding that a normal MVA is between 4 -6cm2 and that when reduced to 2cm2 "hemodynamically" significant mitral stenosis occurs. Anyway, most of my echo post repair the MVA was assessed using the pressure half-time method and the values have been insignificant at 2.42, 4.99, 2.74, 3.1, 2.86...however, those echos which used the planimetry method show a markedly considerable difference in MVA of 1.7, 1.6, with the latest being 1.3. The other values used to assess MS severity; such as, MPG (8-16), PAP 62-78) and PCWP (28) are consistent with a more moderate to severe stenosis...as are my symptoms. Why such a difference in these values and which one is most accurate? Thanks for shedding some light here cuz I'm just plain confused! :confused2:

 

[deek]

Oh, I also should add that the RHC had the MVA at 1.3.

 

[ottagal]

Hi Dee,

I don't have an answer for you, but if you are so inclined to do some reading on this, there is a section in the GUIDELINES AND STANDARDS - Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler.

There is a section on ultrasound/doppler parameters of prosthetic mitral valve function.

Here is the link in pdf: http://www.asecho.org/files/public/PVText.pdf

Hope this helps and you get some answers!

 

[deek]

Hi Dee,

I don't have an answer for you, but if you are so inclined to do some reading on this, there is a section in the GUIDELINES AND STANDARDS - Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler.

There is a section on ultrasound/doppler parameters of prosthetic mitral valve function.

Here is the link in pdf: http://www.asecho.org/files/public/PVText.pdf

Hope this helps and you get some answers!

Thanks so much! I'll check it out.