Mitral valve stenosis

Left ventricle:

• normal sized chamber with normal left ventricular wall thickness.

• no thrombus

• borderline systolic function LVEF: ~50-55%

Right ventricle:

• mildly dilated, basal diameter:~ 4.1cm with borderline systolic function

• TAPSE: 1.6 cm

• tissue Doppler imaging systolic velocity (TDI S'): 10 cm/s

Interventricular septum: intact

Atria:

• left atrium: dilated, area: 41 cm², LAVI: 84 mL/m² with smoke appearance within the chamber (spontaneous echo contrast)

• right atrium: dilated, area: 27 cm²

Aortic valve:

• normal tricuspid

• no aortic regurgitation

Mitral valve:

• thickened and calcified mitral valve leaflet tips with diastolic doming of the anterior mitral valve leaflet giving a "hockey stick" appearance and restricted motion of the posterior mitral valve leaflet. No mitral regurgitation

• mitral valve area by PHT: 0.30cm², transmitral mean pressure gradient: 17mmHg

Tricuspid valve:

• severe eccentric tricuspid regurgitation

Additional findings:

• severely elevated pulmonary pressures (estimated sPAP ~80 mmHg)

• dilated IVC with < 50% inspirational collapse, dilated hepatic veins

The heart is enlarged CTR 15: 26. Enlarged left atrium is seen splaying the carina.

Filling of the pulmonary bay is noted. No hilar or mediastinal adenopathy is seen.

Post mitral valve replacement

• mechanical prosthetic mitral valve is normally functioning. No mitral regurgitation. No paravalvular prosthetic leaks noted

• mitral valve area by PHT: 3.28cm², transmitral mean pressure gradient: 4mmHg, mitral valve PHT:67ms

• no pulmonary arterial hypertension estimated sPAP ~32 mmHg)