Arquivos Brasileiros de Cardiologia (Jun 2005)

Avaliação funcional do apêndice atrial esquerdo ao ecocardiograma transesofágico antes e após valvotomia percutânea na estenose mitral Functional assessment of the left atrial appendage at transesophageal echocardiography before and after percutaneous valvotomy in the mitral stenosis

  • Solange Bernardes Tatani,
  • Orlando Campos Filho,
  • Claudio Henrique Fischer,
  • Valdir Ambrósio Moisés,
  • José Augusto Marcondes de Souza,
  • Cláudia Maria Rodrigues Alves,
  • Angelo Amato Vincenzo de Paola,
  • Antonio Carlos C. Carvalho

DOI
https://doi.org/10.1590/S0066-782X2005000600005
Journal volume & issue
Vol. 84, no. 6
pp. 457 – 460

Abstract

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OBJETIVO: Avaliar os efeitos da abertura efetiva da valva mitral estenótica através da valvotomia percutânea por cateter balão na função do apêndice atrial esquerdo. MÉTODOS: Foram estudados 12 pacientes com estenose mitral sintomática, em ritmo sinusal, submetidos ao ecocardiograma transesofágico antes e após valvotomia percutânea por cateter balão efetiva. Em relação ao apêndice atrial esquerdo, foram analisadas ao Doppler pulsátil as velocidades máximas e respectivas integrais dos fluxos anterógrado e retrógrado, além da fração de ejeção calculada pela planimetria da área desta estrutura. RESULTADOS: Houve aumento significante das velocidades de fluxo anterógrado do apêndice atrial esquerdo após valvotomia percutânea por cateter balão (pré: média de 0,30 m/s; pós: média de 0,47 m/s; pOBJECTIVE: To assess the effects of the relief of the mitral stenosis by percutaneous ballon valvotomy in the function of the left atrial appendage. METHODS: Twelve patients with symptomatic mitral stenosis, in sinus rhythm, were studied. They were submitted to the transesophageal echocardiogram before and after effective percutaneous ballon valvotomy. Concerning the left atrial appendage, the peak flow velocities and the respective integral of the anterograde and retrograde flow, in addition to the ejection fraction calculated through the planimetry of the area of that structure, were analyzed at the pulsatile Doppler. RESULTS: There was a significant increase of the anterograde flow velocity of the left atrial appendage after percutaneous ballon valvotomy (pre: mean of 0.30 m/s; post: mean of 0.47 m/s; p<0.05) and their respective integrals. The same happened with the retrograde flow velocity (pre: mean of 0.35 m/s, post: mean of 0.53 m/s; p<0.05). There was a tendency of increase of the ejection fraction of the left atrial appendage after the procedure (pre: mean of 20%, post: mean of 31%; p=0.08). CONCLUSION: The effective opening of the stenosed mitral orifice resulting from the percutaneous ballon valvotomy determined an improvement of the flow pattern of the left atrial appendage, which can potentially contribute for the reduction of the embolic risk.

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