2 STENOSI MITRALICA REUMATICA lembicommissurecordeIn all patients with rheumatic MS, the leaflets are diffusely thickened by either fibrous tissue or calcificdeposits or both, the two commissures are usually fixed, and the chordae tendineae are usually (but notalways) thickened and fused (Figs. 13 and 14).
11 Pressure Half Time (PHT) tempo che il picco di pressione protodiastolica impiega a dimezzasiDTPHT
12 Riduzione della pressione atriale Sn (DIA) Pressure half-timeAREA = 220/PHTAumento della pressione diastolica ventricolare Sn (Insufficienza aortica)Riduzione della pressione atriale Sn (DIA)DTPHT
13 Pressure half-timeDetermination of Doppler pressure half-time (T1/2) with a bimodal, non-linear decreasing slope of the E-wave. The deceleration slope should not be traced from the early part (left), but using the extrapolation of the linear mid-portion of the mitral velocity profile (right).DTPHT
21 (Carabello BA; Circulation, 2005 SummaryMS is usually caused by rheumatic fever, a disease rare indeveloped countries today but that still persists in a large partof the world. When complicated by AF, rate control andanticoagulation are mandatory in the absence of pressingcontraindications. Once more than mild symptoms exist oronce asymptomatic pulmonary hypertension occurs, mechanicalrelief of MS is indicated. In most cases, such relief isprovided by the durable commissurotomy created at BMV. Inother cases, surgical correction is needed. After these interventions,prognosis is excellent.(Carabello BA; Circulation, 2005
22 DESRIZIONEANATOMIAMITRALICA Punteggio di WILKINSMobilitàIspessimentoCalcificazioniApparato sottovalvolare