Comparison of noninvasive techniques in evaluation of the nontissue cardiac valve prosthesis

The ability of bedside auscultation, echophonocardiography and cinefluoroscopy to detect prosthetic valve malfunction was compared in 81 patients with a Bjork-Shiley aortic or mitral valve prosthesis or a Beall mitral valve prosthesis. In 32 patients with an abnormal mitral valve prosthesis proved by cardiac catheterization, the sensitivities of auscultation, echophonocardiography and cinefluoroscopy were 94, 78 and 88 percent, respectively. In 25 patients with a normal mitral valve prosthesis, the specificities were 96, 64 and 89 percent, respectively. Twelve patients had an abnormal aortic valve prosthesis; the sensitivities of auscultation, echophonocardiography and cinefluoroscopy were 92, 58 and 33 percent, respectively. In 12 patients with a normal aortic valve prosthesis, the specificities were 100, 75 and 92 percent, respectively. Auscultation can detect almost all cases of malfunction of nontissue prosthetic valves. Echophonocardiography and cinefluoroscopy can detect most cases of malfunction of mitral valve prostheses, but false positive studies are common; both procedures are less useful in detecting malfunction of aortic valve prostheses.