Which method should be the reference method to evaluate the severity of rheumatic mitral stenosis? Gorlin's method versus 3D-echo.

INTRODUCTION Several studies have shown a wide variability among different methods to determine the valve area in patients with rheumatic mitral stenosis. Our aim was to evaluate if 3D-echo planimetry is more accurate than the Gorlin method to measure the valve area. METHODS Twenty-six patients with mitral stenosis underwent 2D and 3D-echo echocardiographic examinations and catheterization. Valve area was estimated by different methods. A median value of the mitral valve area, obtained from the measurements of three classical non-invasive methods (2D planimetry, pressure half-time and PISA method), was used as the reference method and it was compared with 3D-echo planimetry and Gorlin's method. RESULTS Our results showed that the accuracy of 3D-echo planimetry is superior to the accuracy of the Gorlin method for the assessment of mitral valve area. CONCLUSIONS We should keep in mind the fact that 3D-echo planimetry may be a better reference method than the Gorlin method to assess the severity of rheumatic mitral stenosis.