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PubMed1988

Anorectal function and defecation dynamics in patients with rectal prolapse.

Seven female patients with clinical rectal prolapse and nine healthy female control subjects were studied with anorectal manometry, external sphincter electromyography, and a saline continence test. Resting anal tone, maximum voluntary squeeze, and rectal functional capacity were significantly decreased in the rectal prolapse patients (p less than 0.02). During defecation attempts, external sphincter or pelvic floor electromyographic activity decreased in all of the control subjects, whereas six prolapse patients showed increased electromyographic activity and one had no change in activity (p less than 0.01). Continence to saline solution was also significantly impaired in prolapse patients (p less than 0.001). Postoperative studies in three patients who underwent repair revealed persistence of abnormal anorectal function and defecation dynamics. Patients with rectal prolapse have impaired resting and voluntary sphincter activity, decreased functional rectal capacity, and impaired continence. The failure of normal relaxation of the external sphincter or pelvic floor during defecation attempts, as demonstrated in the patients described herein, may contribute to the development of prolapse and denervation sphincter injury seen in such patients.

Anal Canal↗
PubMed2002

Impact of preoperative aortic cusp prolapse on long-term outcome after surgical closure of subarterial ventricular septal defect.

BACKGROUND: Previous reports on the long-term outcome of surgical closure of subarterial ventricular septal defect were based on a relatively small number of patients. METHODS: We reviewed the long-term outcome of 135 patients who underwent closure of their defect and, in light of the findings, assessed the impact of preoperative aortic cusp prolapse and surgical interventions on occurrence of aortic regurgitation (AR) in the long-term. The patients were categorized into three groups for comparison: group I consisted of 79 patients with no aortic cusp prolapse and underwent simple closure of ventricular septal defect, group II comprised 39 patients with mild to moderate cusp prolapse who similarly had only closure of the defect performed, whereas group III comprised 17 patients who had additional aortic valvoplasty for greater than moderate to severe cusp prolapse. RESULTS: Group I patients had significantly higher pulmonary arterial pressure (p < 0.001) and ratio of pulmonary blood flow to systemic blood flow (p < 0.001). None of these patients had AR before their operation, and none experienced AR afterward at a median follow-up of 6.1 years. Of the 39 group II patients, 30 (77%) had trivial or mild AR preoperatively. The AR improved in 15 patients, remained trivial or mild in 14 and absent in 7, but progressed to trivial or mild in 3 at a median follow-up of 3.1 years. None required further interventions. In contrast, 14 (82%) of the 17 group III patients had moderate to severe AR before operation. The regurgitation improved in 10, but remained moderate or severe in 4 and worsened further in 3 at a median follow-up of 4.6 years. The freedom from failure of aortic valvoplasty was (mean +/- standard error of the mean) 71%+/-11%, 64%+/-12%, and 43%+/-19% at 1, 5, and 10 years, respectively. An older age at latest follow-up was the only identifiable significant risk factor (p = 0.03). CONCLUSIONS: Our data do not support the need of aortic valvoplasty for mild to moderate aortic cusp prolapse. Close follow-up is warranted in those with greater than moderate to severe cusp prolapse despite valvoplasty as there is continued failure on follow-up. Nothing, however, is better than early closure of defects before development of aortic valve complications.

Adolescent↗
PubMed1984

Ventricular arrhythmias and mitral valve prolapse in childhood.

Although ventricular arrhythmias are well described in adults with mitral valve prolapse, this association remains controversial in children. To assess the incidence of ventricular premature complexes (VPCs), 103 consecutive children with mitral valve (MV) prolapse confirmed by echocardiography were evaluated prospectively by treadmill exercise and ambulatory ECG. A group of 50 normal children with clinical, ECG, or echocardiographic evidence of heart disease who had undergone treadmill exercise and ambulatory ECG served as controls. In the group with MV prolapse, 16 patients had VPCs with treadmill exercise and 39 had VPCs on ambulatory ECG. High-grade ventricular ectopy (multiform VPCs, couplets, or ventricular tachycardia) was recorded in four patients with MV prolapse during treadmill exercise and in eight during ambulatory ECG. In contrast, no control patient had a single VPC in response to treadmill exercise and only four control patients had rare uniform VPCs on ambulatory ECG. Neither physical examination findings, standard ECG results, nor symptoms could be correlated with VPCs in the patients with MV prolapse. Although the prognostic implications of these findings are uncertain, this study demonstrates that potentially serious ventricular arrhythmias are frequently observed in children with MV prolapse.

Adolescent↗
PubMed1994

A population-based study of stroke in the setting of mitral valve prolapse: risk factors and infarct subtype classification.

OBJECTIVE: To determine the frequency of risk factors and the mechanisms of stroke in patients with cerebral infarction and echocardiographically diagnosed mitral valve prolapse in the general population. DESIGN: We conducted a population-based study in Olmsted County, Minnesota, which encompassed the period from 1975 through 1989. MATERIAL AND METHODS: Study subjects were identified by using the Rochester Epidemiology Project medical records-linkage system. Cardiac and neurologic data were summarized, and a two-sided chi 2 test or Fisher's exact test was used for statistical analysis. RESULTS: Among residents of Olmsted County, Minnesota, 33 had echocardiographically diagnosed mitral valve prolapse and a first cerebral infarction between 1975 and 1989. The mean patient age was 71 years, and more than half (52%) were men. Risk factors for stroke included hypertension (55%), smoking (42%), coronary artery disease (27%), atrial fibrillation or flutter (24%), congestive heart failure (21%), hypertensive heart disease (21%), prior myocardial infarction (12%), diabetes (9%), and sick sinus syndrome (3%). Cerebral infarction subtypes were as follows: cardioembolic source (excluding mitral valve prolapse only), 30%; lacuna, 12%; large-vessel atherosclerosis, 9%; other, 6%; and infarction of uncertain cause (including mitral valve prolapse), 42%. CONCLUSION: Most Olmsted County patients with cerebral infarction and echocardiographically diagnosed mitral valve prolapse had other risk factors for stroke, and most had identifiable mechanisms of infarction other than embolism due to mitral valve prolapse.

Adult↗
PubMed2001

Iliococcygeus or sacrospinous fixation for vaginal vault prolapse.

OBJECTIVE: To compare iliococcygeus (prespinous) and sacrospinous fixation for vaginal vault prolapse. METHODS: Between 1994 and 1998, 78 women underwent sacrospinous colpopexy and 50 underwent iliococcygeus fixation for the management of symptomatic vaginal vault prolapse. A matched case-control study was designed to compare the two approaches. The matched variables included age, parity, body mass index, degree of vault prolapse, menopause, sexual activity, constipation, previous prolapse or continence surgery, stress incontinence, and length of review. Thirty-six matched pairs were isolated, resulting in a study with a power of 50% to detect a 20% difference in the success rates between the two groups. RESULTS: The subjective success rate for the iliococcygeus group was 91%; it was 94% for the sacrospinous group (P =.73). The objective success rate was 53% and 67% (P =.36), and the patient satisfaction with surgery was 78 of 100 and 91 of 100 (P =.01) on a visual analogue scale. The mean length of postoperative follow-up was 21 months for the iliococcygeus group and 19 months for the sacrospinous group (P =.52). The recovery time was 54 days in the iliococcygeus group and 39 days in the sacrospinous group (P =.04). No significant difference was seen in the incidence of postoperative cystoceles or damage to the pudendal neurovascular bundle. CONCLUSION: Sacrospinous and iliococcygeus fixation are equally effective procedures for vaginal vault prolapse and have similar rates of postoperative cystocele, buttock pain, and hemorrhage requiring transfusion. The sacrospinous ligament fixation should not be discarded in favor of the iliococcygeus fixation in the management of vaginal vault prolapse.

Adult↗
PubMed2002

Is urethral mobility really being assessed by the pelvic organ prolapse quantification (POP-Q) system?

OBJECTIVE: To estimate the relationship between Q-tip measurement of urethral hypermobility and visual assessment of the urethrovesical junction as assessed by points Aa and Ba of the pelvic organ prolapse quantification (POP-Q) system. METHODS: A total of 274 patients with pelvic organ prolapse or urinary incontinence had preoperative Q-tip test straining angles and POP-Q staging measurements. By the Q-tip test, urethral hypermobility was defined as a straining angle of 30 degrees or greater relative to the horizontal. As defined in the POP-Q system, point Aa is located in the midline of the anterior vaginal wall 3 cm from the external urethral meatus and represents the urethrovesical junction. Point Ba represents the most dependent position of the anterior vaginal wall. The correlation between point Aa of the POP-Q system and the Q-tip test was assessed using the Spearman correlation coefficient. Similar assessments were made for point Ba. RESULTS: Mean age of the 274 subjects was 58.5 +/- 11.8 years; mean parity was 3.1 +/- 1.6. A total of 104 patients reported prior surgery for prolapse or incontinence. Mean Q-tip straining angle was 61 +/- 20 degrees; 258 (94%) had urethral hypermobility. Values of point Aa ranged from -3 cm to +3 cm, with median 0 cm. The correlation coefficient between the Q-tip straining angle and point Aa was r = 0.47 (P <.001). Urethral hypermobility was observed in 95% of patients with stage II prolapse at point Aa and in 100% of patients with stages III and IV prolapse at point Aa. The correlation coefficient between the Q-tip straining angle and point Ba was r = 0.32 (P <.001). CONCLUSION: Although the correlation between the Q-tip straining angle and point Aa of the POP-Q was moderately strong, one value cannot be predicted from the other. The Q-tip test may be unnecessary in patients with stages II, III, and IV prolapse at point Aa as virtually all such patients demonstrate urethral hypermobility.

Female↗
PubMed1997

Transvaginal repair of vault prolapse: a review.

OBJECTIVE: To provide a critical assessment of the published literature on transvaginal reconstructive techniques used to suspend a prolapsed vaginal vault. DATA SOURCE: A Medline data base search and a bibliographic review of the relevant articles were conducted to identify all English-language articles on repair of vaginal vault prolapse. METHODS OF STUDY SELECTION: Our literature search identified 34 articles published in peer-review journals and one article reported in another format, describing five different techniques. TABULATION, INTEGRATION AND RESULTS: The size of each study population, modifications of the original surgical technique, complications, and results were tabulated and summarized for each surgical approach. Only sacrospinous ligament vaginal vault suspension and endopelvic fascia vaginal vault fixation had a sufficient number of cases to allow an informative evaluation of their effectiveness in managing vaginal vault prolapse. Of the 1229 patients who had undergone sacrospinous ligament suspension, 1062 were available for varying periods of follow-up; 193 (18%) of these developed recurrent pelvic relaxation--including 32 vaginal vault eversions, 81 anterior vaginal wall defects, 24 posterior vaginal wall prolapses, and 56 support defects at unspecified or multiple sites. Of the 367 patients who had undergone endopelvic fascia vaginal vault fixation, 322 were available for follow-up ranging from 1 to 12 years; 34 (11%) of these patients developed recurrent pelvic relaxation including nine vaginal vault prolapses, two anterior vaginal wall defects, 11 posterior vaginal wall relaxations, and 12 support defects at unspecified or multiple sites. CONCLUSION: Published experience suggests that sacrospinous ligament suspension and endopelvic fascia fixation are effective in managing vaginal vault prolapse. Because of study limitations--including an absence of standardized outcome evaluation, relatively short follow-up periods, a substantial number of patients lost to follow-up, concomitant surgical procedures, and failure to assess visceral and sexual functions--the true efficacy of these two procedures remains inconclusive.

Fascia↗
PubMed1997

Sacrospinous ligament fixation with transvaginal needle suspension for advanced pelvic organ prolapse and stress incontinence.

OBJECTIVE: To assess the results of sacrospinous ligament fixation with transvaginal needle suspension for the correction of advanced pelvic organ prolapse and stress incontinence. METHODS: Ninety-six women who had pelvic organ prolapse to or beyond the hymen with or without stress incontinence were surgically managed over 3.5 years. Objective follow-up was available on 75 women. The subject group comprised 54 of these women who had stress incontinence and underwent sacrospinous ligament fixation with transvaginal needle suspension. The remaining 21 women who did not have stress incontinence underwent sacrospinous ligament fixation and served as controls. Appropriate vaginal repairs were performed as needed in both groups. RESULTS: The mean duration of follow-up was 24 months (range 7-72) for the subjects compared with 24.3 months (range 3-53) for the controls. Eighteen subjects (33%) developed recurrent prolapse to or beyond the hymen. Additionally, five (9%) subjects developed recurrent stress incontinence and nine (17%) complained of urge incontinence. Four (19%) controls developed recurrent prolapse, two of whom also have urge incontinence. There was no statistical difference in the mean duration of follow-up or the incidence of recurrent prolapse between subjects and controls. CONCLUSION: Despite the absence of statistical significance, we believe that the 33% recurrent prolapse rate associated with sacrospinous ligament fixation and transvaginal needle suspension is clinically important.

Aged↗
PubMed1998

Size of the urogenital hiatus in the levator ani muscles in normal women and women with pelvic organ prolapse.

OBJECTIVE: Compare urogenital hiatus size in normal women and women with pelvic organ prolapse. METHODS: The sagittal and transverse urogenital hiatus diameters were measured and hiatus area calculated in 300 women whose support was scored using a modified Baden system. RESULTS: In women with normal support and without prior surgery, hiatus area was 5.4 cm2 (+/-1.71 standard deviation [SD], n = 197). In women with uncorrected clinical prolapse (grade 2-3), the area of the hiatus was enlarged (9.6 cm2 +/- 3.97, n = 34, P < .05) and became larger with progressive prolapse (grade 0, 5.4 cm2 +/- 1.71, n = 197; grade 1, 7.3 cm2 +/- 1.91, n = 27; grade 2, 8.3 cm2 +/- 2.45, n = 18; grade 3, 11.0 cm2 +/- 4.90, n = 16). When matched for age and parity, prolapse patients had a larger hiatus than normal women. Women with recurrent prolapse had a larger hiatus than cured women (13.3 cm2 +/- 3.86, n = 8 compared with 8.1 cm2 +/- 2.44, n = 16, P < .05) or women with recurrence after one operation (8.9 cm2 +/- 1.77, n = 18, P < .05). Hiatus size in patients surgically cured (8.3 cm2 +/- 2.44, n = 16) did not return to normal (5.4 cm2 +/- 1.71, n = 197, P < .05). Increasing area of the hiatus was correlated with an increase in anterior-posterior diameter (r2 = 0.9, P < .05), was less attributable to increased transverse diameter (r2 = 0.6, P < .05), and was not related to thickness of the perineal body (r2 = 0.0, P > .05). CONCLUSION: Increasing pelvic organ prolapse is associated with increasing urogenital hiatus size; the hiatus is larger after several failed operations than after successful surgery or single failure.

Adult↗
PubMed2001

Promontofixation for the treatment of prolapse.

Genital prolapse is a common problem in women. The wide variety of surgical techniques used to treat this problem demonstrate how difficult it is to manage. Laparoscopic surgery offers a new approach. It allows a good view of the anterior and posterior compartments so that a global approach for the prolapse is possible by the same surgical route. Traditional promontofixation can be combined with a new approach to the posterior compartment. Laparoscopic promontofixation through installation of an intervesicouterine prosthesis for the treatment of hysterocele and cystocele is associated with paravaginal repair of lateral defects and a Burch anterior colposuspension for urinary stress incontinence. When combined with laparoscopic treatment of rectocele by myorrhaphy and reinforcement of the fascia by means of a prosthesis, it provides a complete range of treatment for all types of feminine prolapse. After 20 years of experience through laparotomy, promontofixation using a triangle has been carried out by laparoscopy at the authors' center since 1991 in an attempt to eliminate the cystocele by solidly anchoring the uterus and bladder floor to the promontory. This laparoscopic technique follows the usual steps for pelvic prolapse repair: 1. Total or subtotal hysterectomy or suspension of the uterus is performed in such a way that it returns to normal physiologic position, and a solid subvesical floor is created. 2. The physiologic axis of the vagina is restored by creating a strong, low posterior point of support and by performing culdoplasty. 3. Evident or latent stress incontinence is treated. It would be pointless to treat the hysterocele on its own because, once the prolapse has been cured, the subvesical mass will disappear and allow urinary incontinence to appear. 4. Reconstruction of the posterior rectovaginal support structures seems to be mandatory and is carried out in almost all cases. The first phase of the laparoscopic approach to pelvic prolapse allowed the authors to explore the technical aspects. Several approaches are possible by laparoscopy. Herein, the authors report 8 years of technical research and assessment. This experience confirms the tremendous potential of laparoscopic surgery for the treatment of all aspects of this pathology by the same route. Stress incontinence, cystocele, hysterocele, rectocele, or enterocele can be treated. The operative time is longer than with the open route, and the surgeon must be highly experienced. Based on their experience, the authors are discovering new concepts. More data are required before a conclusion can be drawn concerning this promising new approach.

Culdoscopy↗
PubMed2002

[Obstructive anuria secondary to uterine prolapse].

The prevalence of obstructive uropathy linked to uterine prolapse ranges between 4% and 80%, depending on the series, probably due to the varying degree of severity of the prolapses under consideration. Renal failure or anuria is an unusual complication. Several etiopathogenic theories regarding obstructive uropathy secondary to prolapse have been put forward: ureteral compression by the uterine vessels, severe urethral angulation, ureteral compression against levator ani muscles and the elongation and narrowing of the distal ureter. The major radiological exploration used in studying the urinary tract of these patients is intravenous urography in bipedestation. Emergency treatment for obstructive anuria resulting from a uterine prolapse consists of manually replacement of the prolapse. Surgery is considered to be the definitive ideal treatment, although in the case of surgical or anaesthetic high risk patients, inserting a permanent pessary may constitute a satisfactory solution. We present a case of obstructive anuria resulting from uterine prolapse, which was successfully treated with the insertion of a ring pessary.

Aged↗
PubMed1999

What predisposes young women to genital prolapse?

OBJECTIVE: To determine the predictive factors for genital prolapse. STUDY DESIGN: We studied 85 young (< or = 45 year old) women who had been operated on for genital prolapse. The control group consisted of women of the same age operated on for benign ovarian tumor. RESULTS: In the study group the number of deliveries was higher and the babies were heavier than in the control group. However, the study group had not had more instrumental deliveries. In addition, the women with prolapses more often had operations of abdominal hernias and also had more chronic pulmonary disease, e.g. asthma. The incidence of preterm delivery was the same in the women with genital prolapse as in the controls. Familial incidence of genital prolapse was about 30%. CONCLUSION: Our study confirms that there are both acquired and congenital factors that predispose women to genital prolapse.

Adult↗
PubMed2004

Frequency of anal incontinence and results of pelvic viscerography in 291 women with pelvic organ prolapse.

OBJECTIVES: To determine the prevalence of anal incontinence in a population of 291 women with pelvic organ prolapse and evaluate the results of pelvic viscerogram in this situation. MATERIALS AND METHODS: Each patient answered a standardized questionnaire on medical, obstetric and surgical past histories and answers were logged in a database. The viscerograms were performed by a single specialized radiologist. RESULTS: All patients but one were parous. The prevalence of anal incontinence was 26.1%. Stress urinary incontinence and urge urinary incontinence were significantly associated with anal incontinence. No obstetric or surgical risk factor for anal incontinence was demonstrated. Viscerography demonstrated rectoceles (n=86, 29.1%), enteroceles (n=77, 26.5%), cystoceles (n=174, 59.8%), and intra-anal rectal prolapse (n=106, 36.4%). A significant association was found between intra-anal rectal prolapse and anal incontinence. CONCLUSION: Anal incontinence is frequent in patients with pelvic organ prolapse, even more so in the presence of urinary incontinence, and should be investigated by pelvic viscerography. Pelvic floor dysfunction is frequently associated with enteroceles, rectoceles and rectal prolapse. Pelvic viscerograms should be systematically performed in the diagnostic work-up in patients with pelvic organ prolapse when surgical treatment is considered.

Adult↗
PubMed1984

Angiographic diagnosis of posterior mitral valve leaflet prolapse.

The left ventricular cineangiograms of 22 asymptomatic, apparently healthy male aviators without noninvasive (echocardiographic or auscultatory) evidence of mitral valve prolapse were reviewed and compared with those of 12 men with noninvasive evidence of mild mitral valve prolapse. The maximal protrusion of the posterior mitral valve leaflet superior and posterior to a line perpendicular to the long axis of the left ventricle at end-systole was measured from the right anterior oblique left ventricular cineangiogram by repeated observation of left ventricular inflow. The values were 7.5 +/- 1.6 mm in patients without mitral valve prolapse and 11.2 +/- 3.4 mm in patients with mitral valve prolapse (mean +/- 1 standard deviation). This measurement did not exceed 11 mm in any patient without prolapse. It is concluded that: 1) with meticulous attention to angiographic landmarks of the left ventricular inflow area, the limits of normal systolic posterior mitral leaflet motion can be defined; and 2) systolic motion outside these limits constitutes a quantitative criterion for the angiographic diagnosis of mitral valve prolapse.

Adult↗
PubMed1988

Mitral valve dimensions and motion and familial transmission of mitral valve prolapse with and without mitral leaflet billowing.

To test the hypothesis that mitral valve prolapse may be due either to billowing of mitral leaflets into the left atrium or to dynamic expansion of the mitral anulus, mitral leaflet and annular dimensions and motion were measured by computer-assisted two-dimensional echocardiography in 35 normal adults and 48 subjects with auscultatory and M-mode echocardiographic evidence of mitral prolapse. Among normal subjects, mitral leaflet and annular dimensions tended to be larger compared with body size or left ventricular size in women than in men. Mitral leaflet billowing was observed in 24 (50%) of 48 patients with mitral prolapse and 0 of 35 normal subjects (100% specificity). The 24 patients without leaflet billowing had greater systolic expansion of the mitral anulus (p less than 0.0001) than did normal adults or patients with leaflet billowing (41 +/- 14% versus 27 +/- 12% and 22 +/- 11%, respectively) and a significantly lower body mass index (p less than 0.005 versus normal group). The ratio of anterior plus posterior mitral leaflet length to end-systolic annular diameter was lower in patients with prolapse without leaflet billowing than in normal subjects (1.09 +/- 0.12 versus 1.19 +/- 0.15, respectively, p less than 0.01) or patients with leaflet billowing (1.21 +/- 0.17, p less than 0.05). Among 35 relatives with mitral prolapse in the families of 23 patients with prolapse, the pattern was the same as in the proband in 31 (89%) (p less than 0.000002).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Self-reported uterine prolapse in a resettlement colony of north India.

The aims of this study are to estimate the prevalence of self-reported uterine prolapse and to determine the treatment-seeking behavior of the respondents. Participants of this study are married women of Dadu Majra colony, Chandigarh, India, January-February, 1996. A house-to-house screening of the women was done by a nursing student utilizing a checklist of indicator symptoms of uterine prolapse. All women reporting such symptoms were interviewed further. Among the 2,990 women surveyed, 227 (7.6%) reported symptoms of uterine prolapse. Of the 227 women with self-reported uterine prolapse, 128 (57%) had not taken any treatment, 28 went to a traditional birth attendant (TBA), and 47 (21%) consulted a doctor. Thirty-eight women were advised to have an operation, but only eight complied. Other treatments used by small numbers of women included the use of a ring pessary or alcohol-soaked swab and heel pressure technique. Reasons for non-consultation included shyness (80; 63%), lack of cooperation by the husband, lack of time (80; 63%) and lack of money (74; 58%). The prevalence of prolapse was significantly higher in women with higher parity. More than 7% of the women reported symptoms of uterine prolapse.

Adolescent↗
PubMed2001

Timing of fornix reconstruction for postoperative conjunctival prolapse.

BACKGROUND AND OBJECTIVE: To describe fornix reconstruction for conjunctival prolapse occurring after ocular surgery. MATERIALS AND METHODS: Two patients with persistent conjunctival prolapse of variable duration following ocular surgery underwent fornix reconstruction using the method described by Barrett. The two patients underwent different surgical methods. In the second patient, no attempt was made to include the malar periosteum. RESULTS: Case 1 with longer duration of prolapse needed further surgery to excise residual prolapsing conjunctiva that had hyperplastic squamous epithelium. Case 2 in which fornix reconstruction was done 2 months after prolapse showed a good result after only one surgical operation. CONCLUSION: Forniceal reconstruction is recommended for persistent postoperative conjunctival prolapse. Early surgery appears to have better results.

Adolescent↗
PubMed2003

Evaluation of mitral valve prolapse using newly developed real-time three-dimensional echocardiographic system with real-time volume rendering.

The development of a real-time three-dimensional (RT3D) image acquisition system and direct digital links between ultrasound equipment and the data processing computer facilitate improved 3D image reconstruction. However, at present time, it is hard to promptly display 3D images and is also ineffective for a practical use. The objective of this study was to assess the feasibility of a new transthoracic RT3D echocardiographic system for evaluation of mitral valve prolapse. Eighteen patients with mitral valve prolapse diagnosed by transthoracic two-dimensional (2D) echocardiography and M-mode were examined through this technique (11 male, mean age 42 +/- 17 years). Since visualization of mitral valve from apical four-chamber view was better than that of the parasternal approach, only apical approach was used for mitral valve evaluation. This system is capable of acquiring volumetric data from mechanical scanning of the phased-array transducer (3.5 MHz) as well as displaying the volume rendered images of the structure without storing the image data and reconstruction of the object. The prolapse of leaflet could be seen in 14/ 18 (77%) of patients with mitral valve prolapse based on conventional echocardiography. The newly developed transthoracic RT 3D ultrasound system without a reconstruction process seemed to be a useful noninvasive tool for diagnosis of mitral valve prolapse and detection of prolapsed leaflet or scallop, which is very important for deciding on a reliable surgical technique.

Adult↗