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Microbubbles and mitral valve prostheses - transesophageal echocardiographic evaluation
Summary
Microbubbles are common in mechanical mitral valves, especially St. Jude and Medtronic types, but not tissue valves. Their presence correlates with better ventricular function, suggesting a cavitation-like process.
Area of Science:
- Cardiovascular Medicine
- Echocardiography
- Prosthetic Heart Valves
Background:
- Spontaneous echocardiographic contrast, described as microbubbles, is observed in patients with prosthetic heart valves.
- The association between microbubbles and specific prosthetic valve types, ventricular function, and mitral regurgitation requires further investigation.
Purpose of the Study:
- To determine if microbubbles are linked to specific mitral valve prostheses.
- To explore the relationship between microbubbles, ventricular function, and mitral regurgitation.
Main Methods:
- Retrospective review of 109 transesophageal echocardiography studies (74 patients) with prosthetic mitral valves.
- Data collected from UCLA Medical Center between May 1989 and February 1995.
- Independent review by two observers.
Main Results:
- Microbubbles were observed in 74% of St. Jude valves, 67% of Bjork Shiley valves, and 100% of Medtronic valves.
- No microbubbles were detected in tissue valves (0%).
- Patients with ejection fraction >45% showed a higher likelihood of microbubbles; no significant association with mitral regurgitation was found.
Conclusions:
- Microbubbles are prevalent in mechanical mitral prostheses compared to tissue valves.
- Formation appears dependent on systolic ventricular function, possibly involving a cavitation-like phenomenon related to valve closure dynamics.
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