Right-to-left Atrial shunting Following Percutaneous Mitral Commissurotomy: Color Doppler Echocardiographic Detection from the Right Parasternal Approach.
八木 登志員, 吉川 純一, 吉田 清, 皆越 真一, 赤阪 隆史, 前西 文秋, 紺田 利子, 桜井 英一, 藤井 洋子, 小形 恵子
Toshikazu YAGI, Junichi YOSHIKAWA, Kiyoshi YOSHIDA, Shinichi MINAGOE, Takashi AKASAKA, Fumiaki MAENISHI, Toshiko KONDA, Hidekazu SAKURAI, Youko FUJII, Keiko OGATA
Department of Cardiology, Kobe General Hospital
Right parasternal approach, Right-to-left atrial shunting, Percutaneous transluminal mitral commissurotomy
Right-to-left atrial shunting demonstrated by color Doppler echocardiography using the longitudinal right parasternal approach was reported in four patients with mitral stenosis following percutaneous transluminal commissurotomy (PTMC). All four patients experienced complications with severe tricuspid regurgitation before PTMC. Right-to-left atrial shunting on the color Doppler echocardiogram appeared during systole from the right atrium into the left atrium through the atrial septum coincided with the bulging of the atrial septum towards the left atrium due to impinged tricuspid regurgitant jet. This right-to-left atrial shunting disappeared in all patients from one to four months after PTMC.