Early evaluation of prosthetic valves using Doppler echocardiography

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Abstract

The object of this review was to evaluate prosthetic valve function with Doppler echocardiography during the early postoperative period (less than 15 days following surgery). The study group consisted of 60 patients with prosthetic valves (PV) and no clinical evidence of prosthetic malfunction, 40 patients with aortic val- ve prosthesis (A VP) and 20 patients with mitral valve prosthesis (MVP). Of the 40 patients with A VP, 28 had Starr prosthesis (S), 8 had Saint Jude prosthesis (SJ) and 4 had biologic prosthesis (B). Among the 20 patients with MVP, 5 had S, 10 had SJ and 5 had B prosthesis. The maximal gradient, mean gradient and mitral valve area were measured in all patients. Thirteen patients with A VP had valve areas (VA) measured according to the continuity equation method. The presence of valve insufficiency was evaluated in all patients graded in absent, mild, moderate and severe. In the patients with A VP no stadistically significant differences were found in the maximal gradient or mean gradient among the different type prosthesis. In those patients with AVP and valve insufficiency, maximal gradient and mean gradient were higher. In the 13 patients with AVP and measured VA those with S had smaller areas than those with. SJ or B prosthesis with ourt statistical significance. This trend persisted even alter correcting the gradient by the left ventricular out flow tract velocity but with out showing statistical significance. In the group of patients with MVP no statistically significant differences in maximal gradient, mean gradient and VA among the different type prosthe- sis were found. We conclude that the early postoperative Doppler evaluation of PV may help in the detection of prosthetic function abnormalities yet not evident clinically.