Noninvasive diagnosis of prosthetic mitral valve malfunction

A patient with a Kay-Shiley mitral prosthesis had abnormal intermittent systolic tilting of the prosthetic disc by cinefluoroscopy. Echocardiography revealed an abnormal "atrial emptying index" consistent with mitral obstruction. Catheterization revealed mitral regurgitation without stenosis. At surgery, there was no prosthetic orifice obstruction. It was concluded that the atrial emptying index may be abnormally low in prosthetic mitral regurgitation without stenosis.