All concepts, explanations, trials, and studies have been
re-written in plain English and may contain errors. I am
not a doctor
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New Findings in Treatments
By Dr. Ileana Pina.
From American Heart Association Scientific Sessions of 2003

Measuring Mitral Regurgitation

Measuring mitral valve regurgitation to see if it requires
surgical repair is done by TEE - an echo done with a
miniature transducer that you "swallow" while sedated but
you not unconscious. Many surgeons use a TEE done while you
are already under complete (general) anesthesia.
	In a trial by Mihalatos in New York, TEE done under
"conscious sedation" was compared to TEE done under
complete general anesthesia. Measurements were taken and
then taken again when chemicals were used to change the
heart's work load.
	The results suggest significant underestimation of
mitral valve regurgitation by at least one full grade in
many patients. Stressing the heart with chemicals while
under general anesthesia improved, but did not eliminate,
this problem.
	This suggests that the gold-standard for measuring
mitral valve function is TEE done in a sedated but conscious
patient.