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Doppler echocardiographic characteristics of the Carpentier-Edwards xenograft
Insights
Doppler echocardiography helps define normal velocity ranges for Carpentier-Edwards xenografts. Over time, Doppler indices for mitral and aortic prostheses show increased obstruction, indicating potential long-term changes.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- The Carpentier-Edwards xenograft is a common prosthetic heart valve.
- Establishing normal hemodynamic ranges is crucial for monitoring valve function post-implantation.
Purpose of the Study:
- To define normal velocity ranges for Carpentier-Edwards xenografts in mitral, aortic, and tricuspid positions.
- To investigate the relationship between Doppler indices and time since valve implantation.
Main Methods:
- Doppler echocardiography (pulsed and continuous wave) was used to study 71 prosthetic valves (38 mitral, 24 aortic, 9 tricuspid).
- Patients were assessed at a mean of 38 months post-surgery, with clinically normal valve function and no heart failure signs.
Main Results:
- Mean peak velocities were: aortic 244 cm/s, mitral 164 cm/s, tricuspid 150 cm/s.
- Weak correlations were found between peak velocity and time since implantation for aortic valves (r=0.54) and pressure half-time and time for mitral valves (r=0.44).
- Doppler indices of obstruction increased significantly with time for mitral and aortic prostheses.
Conclusions:
- Normal velocity ranges for Carpentier-Edwards xenografts were established using Doppler echocardiography.
- Long-term follow-up reveals increasing obstruction indices for mitral and aortic xenografts, highlighting the need for monitoring.
Abstract:
In order to define ranges of normal velocities for the Carpentier-Edwards xenograft, 38 mitral, 24 aortic and 9 tricuspid prostheses were studied with pulsed or continuous wave Doppler at a mean interval of 38 months following surgery. All patients had clinically normal prosthetic valve function and no clinical or radiographic signs of heart failure. Mean peak velocity across aortic prostheses was 244 cm s-1 (SD 48). There was weak correlation (r = 0.54, P less than 0.01) between peak velocity and time since valve implantation, but no significant difference in peak velocity across valves of different size. In the mitral position, mean peak velocity was 164 cm s-1 (SD 24) and mean pressure half time 90 ms (SD 23). There was again no significant difference between valves of different size. There was a weak correlation between pressure half time and time since implantation (r = 0.44, P less than 0.01), but there was no relationship between the latter and peak velocity. In the tricuspid position, mean peak velocity was 150 cm s-1 (SD 12) and mean pressure half time 163 ms (SD 50). The Doppler indices of obstruction to blood flow for prostheses in the mitral and aortic positions showed a significant increase with time after implantation.
