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[Mitral prostheses with and without dysfunction: evaluation using 2-D Doppler echocardiography].

L Bernardes1, J Abreu, R Soares

  • 1Serviço de Cardiologia, Hospital de Santa Marta, Lisboa.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|December 1, 1990
PubMed
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This study found that a peak velocity (PV) over 2 m/s in mitral valve prostheses indicates abnormal function. Bjork-Shiley mechanical valves showed better hemodynamics than bioprosthetic valves.

Area of Science:

  • Cardiovascular Medicine
  • Biomedical Engineering
  • Echocardiography

Background:

  • Mitral valve replacement is a common procedure.
  • Understanding prosthetic valve function is crucial for patient management.

Purpose of the Study:

  • To evaluate the flow characteristics of normally and abnormally functioning mechanical and bioprosthetic mitral valves.
  • To establish reference values for prosthetic mitral valve assessment.

Main Methods:

  • Prospective study involving 61 asymptomatic patients with normally functioning mitral prostheses and 15 with abnormal function.
  • 2D-Doppler echocardiography was used to record prosthetic mitral flow.
  • Analyzed parameters included peak velocity (PV), peak gradient (PG), mean gradient (MG), pressure half time (PHT), area (A), and regurgitation (R).

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Main Results:

  • Normally functioning Bjork-Shiley (B-S) prostheses exhibited distinct hemodynamic profiles compared to bioprosthetic (B) valves, with higher PG and MG, and smaller areas.
  • A significant correlation was observed between PG and MG in both mechanical and bioprosthetic valves.
  • Abnormal function was associated with increased PV, and regurgitation was detected in 100% of bioprosthetic and 72% of mechanical valves with dysfunction.

Conclusions:

  • Peak transprosthetic velocity greater than 2 m/s is a sensitive and specific indicator of abnormal prosthetic mitral valve function.
  • Bjork-Shiley mechanical prostheses appear to offer a more optimal hemodynamic profile than bioprosthetic valves.
  • The collected data can serve as reference values for the follow-up of patients with these prosthetic devices.