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Occurrence of a left ventricular third heart sound in incompetent mitral heterografts
Insights
Severe mitral incompetence after aortic valve replacement can cause early third heart sounds. This challenges the common belief that these sounds stem from mitral valve tension during ventricular filling.
Area of Science:
- Cardiology
- Cardiac Surgery
- Physiology
Background:
- Severe mitral incompetence can occur after aortic valve replacement.
- Phonocardiography and apex cardiography are used to assess cardiac sounds and dynamics.
Purpose of the Study:
- To describe three cases of severe mitral incompetence following heterograft aortic valve replacement.
- To investigate the origin of early third heart sounds in these specific cases.
Main Methods:
- Case series analysis of three patients.
- Phonocardiography to record heart sounds.
- Apex cardiography to record ventricular dynamics.
Main Results:
- All three patients exhibited an early third heart sound on phonocardiograms.
- Two patients showed a prominent early diastolic peak on apex cardiograms.
- The observed findings challenge the established theory of third heart sound generation.
Conclusions:
- Early third heart sounds in severe mitral incompetence post-aortic valve replacement may not be solely due to mitral valve tautening.
- Further research is needed to fully elucidate the mechanisms behind third heart sound production in such conditions.
Abstract:
Three cases of severe mitral incompetence after heterograft aortic valve replacement are described. In all cases an early third heart sound was recorded on the phonocardiograms. In two cases a prominent early diastolic peak was also recorded on the apex cardiograms. These findings do not support the widely held view that the third heart sound is produced by sudden tautening of the mitral valve structures during the rapid filling phase of the left ventricle.