Criteria to detect mitral prosthetic valve dysfunction via continuous wave Doppler echocardiography

M. Shigenobu, S. Sano

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

To detect the diagnostic criteria for mitral prosthetic valve dysfunction, Doppler echocardiography was used to assess valve function following mitral valve replacement in 100 patients [50 with St. Jude Medical (SJM) valves, 50 with Bjork-Shiley (B-S) valves]. Mitral valve area (MVA) was calculated by dividing a constant of 220 by pressure half time (PHT) measured via Doppler technique [220/PHT]. The relationship of MVA to left ventricular function, geometric valve area (GVA) of the prosthetic valve, body surface area (BSA), and maximum disc-opening angle (maxOA) were assessed. In the SJM valves, MVA significantly correlated with valve area index (GVA/BSA). The %area index [(MVA/valve area index) x 100] was 100.2 ± 12.8% on the average and no patients with the SJM valve showed the %area index of less than 73%. There was no incidence of valve dysfunction in the SJM valves. We concluded from these results that if the %area index is less than 73% (mean - 2SD), the SJM valve dysfunction should be diagnosed. When the B-S valves were examined, there were 19 patients in whom the maximum opening angle had decreased to under 58 degrees. These patients also had decreased MVA and %area index. Evaluation of the relationship between the maximum opening angle and the %area index revealed that the patients in whom the maximum opening angle had diminished to under 50 degrees had low %area index (of less than 70%). In the B-S valves, eight out of the nine patients who showed the %area index less than 70%, underwent reoperation because of valve dysfunction due to thrombus or pannus formation around the prosthetic valves. We determined that if the %area index is less than 70%, the B-S valve dysfunction should be diagnosed.

Original languageEnglish
Pages (from-to)301-306
Number of pages6
JournalJournal of Cardiovascular Surgery
Volume35
Issue number4
Publication statusPublished - Jan 1 1994

Keywords

  • Bjork-Shiley valve
  • St. Jude Medical valve
  • echocardiography Doppler
  • mitral prosthetic valve dysfunction

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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