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Table 2 Advantages and disadvantages of three methods of estimation of left-sided valve's regurgitation.

From: Methods of estimation of mitral valve regurgitation for the cardiac surgeon

Mode of evaluation

Advantages

Disadvantages

Angiography

-simultaneous calculation of SVR, PVR, LVEDP, PCWP, EF, etc (1,6)

-easy interpretation by cardiologists and cardiac surgeons (6)

-invasive method, risk of complications(5)

-misinterpretation in double valve disease (1,6)

-higher cost (5,6)

-temporarily affects hemodynamic of patient (SVR, PVR) and obscure the results (5)

-time-consuming

Doppler

- non-invasive method

- no risks

- low-cost

- time-consuming

- does not affect hemodynamically the patient

- semi-quantitative

- overlapping structures

- "bad" window

- operator depending

discomfort+hemodynamic interaction of TEE – limitations (see text)

- influence of site of Jet

MRI

- measurement of LVEDV, LVESV, LV mass

- no risk

- non invasive tool

- precise and valid estimation (23,24)

- does not need suppression or anaesthesia (such as TEE)

- estimation of myocardial function and viability (9,29)

- respiratory interference

-not-hemodynamic measurement

- not-anatomic information

- discomfort for the patient

- artefacts in the case of metallic materials (40,41)

  1. (SVR: systemic venous resistance, PVR: pulmonary venous resistance, PCWP: pulmonary capillary wedge pressure, EF: enjection fraction, LVEDV: left ventricle end diastolic volume), LVESV: left ventricle end systolic volume, LV mass: left ventricle mass, TEE: Transesophageal echocardiography).