Comparison of transthoracic and transesophageal echocardiography for assessment of left-sided valvular regurgitation.

To compare transthoracic and transesophageal echocardiography in the clinical assessment of left-sided valvular regurgitation, 118 patients who underwent both transesophageal and transthoracic echocardiographic studies within a 24-hour period were included in this study. Presence or absence of aortic regurgitation was identified concordantly by both techniques in 93 patients (79%). Complete agreement between both techniques was found in 88 patients (75%). Presence or absence of mitral regurgitation was identified concordantly by both techniques in 89 patients (75%). Complete agreement in grade was found in only 74 patients (63%). Twenty-nine patients (25%) had mitral regurgitation detected by transesophageal echocardiography, but not by transthoracic echocardiography. Four of these patients (14%) had significant (2 to 3+) mitral regurgitation. Differences between transesophageal and transthoracic echocardiography do not appear to be clinically important in patients with aortic regurgitation. In mitral regurgitation, significant differences exist between these 2 techniques, with transesophageal echocardiography being much more sensitive.