Real-world echocardiography in XXXX referred for mitral valve surgery: the gap between guidelines and clinical practice.

@entity1 @entity340 @entity997 @entity339
BACKGROUND AND AIM OF THE STUDY: @entity339 ( @entity339 ) is a common disorder for which mitral valve surgery is an established therapy. Although surgical indications are clearly defined for the management of @entity340 , a gap exists between current guidelines and their effective application. The study aim was to provide an insight into the diagnostic information provided for cardiac surgeons before performing mitral valve surgery. METHODS: The source documents and echocardiographic studies of 100 @entity1 , referred by nine hospitals, were screened for arguments for @entity339 severity justifying referral for surgery. Details of the documented @entity339 mechanism, mitral annulus (MA) size, @entity997 ( @entity997 ) severity and annulus size were also noted. RESULTS: According to the referring physician, @entity339 was severe in 83% and moderate-to-severe in 17%. In the great majority of @entity1 (98%) the @entity339 mechanism was mentioned, although specific information on the prolapsing scallops was available in only 17% of cases. The recommended primary determinants of @entity339 severity, vena contracta and proximal isovelocity surface area (PISA) were measured in only 22% and 31% of @entity1 , respectively. In 94% of @entity1 with available PISA information this was described only qualitatively. Correct image expansion using the zoom mode was performed in only 25% of these @entity1 , and a correct adaptation of the Nyquist limit in only 6%. Tricuspid annulus measurements guiding the need for concomitant tricuspid valvuloplasty in @entity1 with less than severe @entity997 were reported in only 6% of @entity1 . CONCLUSION: These data demonstrate a clear and important gap between current guidelines and real-world practice with regards to the echocardiographic diagnostic information provided to the surgeon before performing mitral valve surgery.
