Valvuloplasty Diagnosis and Tests

The echocardiogram, also known as the “echo,” serves as the primary diagnostic tool for mitral stenosis. It uses ultrasound waves to create a moving picture of the heart. There are no needles and no radiation involved in the standard test. It allows the doctor to see the valve leaflets moving, measure the thickness of the valve, and calculate the size of the opening.

Transthoracic Echocardiogram (TTE)

This is the standard ultrasound performed on the surface of the chest. A technician applies gel to the chest and moves a wand-like device called a transducer over the heart area. The sound waves bounce off the heart structures and create an image on a monitor. The TTE provides a wealth of information. It shows the shape of the valve, whether the leaflets are fused, and how much calcium is present. It also measures the pressure difference (gradient) between the upper and lower chambers. A high gradient confirms that the blood is struggling to get through.

Transesophageal Echocardiogram (TEE)

Occasionally, the standard echo does not provide enough detail, especially if the doctor needs to examine for blood clots before a procedure. In these cases, a transesophageal echocardiogram (TEE) is used. The patient is sedated, and a small, flexible tube with an ultrasound probe on the tip is gently guided down the throat into the esophagus (food pipe). Since the esophagus sits directly behind the heart, this pathway provides an incredibly clear, close-up view of the mitral valve without the ribs or lungs getting in the way. TEE is crucial for ruling out clots in the left atrium, which would make valvuloplasty dangerous.