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Echocardiographic assessment of prosthetic mitral valves in children

Taiyu Hayashi1, Ryo Inuzuka2, Hiroshi Ono1

  • 1Division of Cardiology, National Center for Child Health and Development, Tokyo, Japan.

Echocardiography (Mount Kisco, N.Y.)
|November 3, 2016
PubMed

Insights

Doppler-derived hemodynamic parameters in children change with prosthetic mitral valve (PMV) size. The velocity-time integral (VTI) ratio and indexed effective orifice area (iEOA) can help detect PMV obstruction.

Area of Science:

  • Pediatric Cardiology
  • Echocardiography
  • Prosthetic Valve Monitoring

Background:

  • Mechanical bileaflet prosthetic mitral valves (PMVs) are used in children.
  • Somatic growth can alter the relative size of PMVs, potentially affecting their function.
  • Monitoring PMV function is crucial for pediatric cardiac care.

Purpose of the Study:

  • To investigate how Doppler-derived hemodynamic parameters change with relative PMV size in children.
  • To evaluate the diagnostic utility of these parameters for detecting PMV obstruction.

Main Methods:

  • Retrospective review of 26 echocardiograms from 15 mechanical bileaflet PMVs in 12 children.
  • Analysis of peak E velocity, mean pressure gradient (PG), pressure half time (PHT), velocity-time integral (VTI) ratio, and indexed effective orifice area (iEOA).
  • Correlation of parameters with PMV size z-scores and assessment for obstruction.

Main Results:

  • Significant correlations were found between normally functioning PMV parameters and PMV size z-scores (e.g., iEOA r=0.79).
  • The VTI ratio and iEOA deviated beyond ±2 standard errors in patients with obstructive PMVs.
  • Two cases of PMV obstruction due to thrombosis were identified.

Conclusions:

  • Doppler-derived hemodynamic parameters in children should be interpreted relative to PMV size.
  • Deviations in VTI ratio and iEOA from predicted values suggest potential prosthetic valve obstruction.
  • These parameters aid in assessing PMV function and detecting obstruction in pediatric patients.
Abstract

Keywords:
Doppler echocardiographymitral valve prosthesisthrombus

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