TEE view of severe mitral stenosis

Midesophageal four-chamber view of the mitral valve (A) at mid-diastole in a patient with severe mitral stenosis. Echocardiographic features of mitral stenosis include thickened or calcified mitral valve leaflets, commissural fusion causing decreased separation of the leaflets in diastole, and an enlarged left atrium with spontaneous echo contrast. The severity of mitral stenosis was quantified by continuous-wave Doppler measurement demonstrating a peak transvalvular pressure gradient of 18 mmHg (4 x Vmax² = 4 x 2.142). The pressure half-time was measured at 254 ms, resulting in a calculated mitral valve area of 0.87 cm².