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[Valve prostheses and transesophageal echocardiography]
N Espinola Zavaleta1, G de la Rosa, E Tamayo Rebolledo
1Departamento de Ecocardiografia, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Insights
Transesophageal echocardiography effectively detects prosthetic valve dysfunction. Nearly half of studied valves showed issues, including mechanical valve obstruction and bioprosthetic leaflet problems.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Prosthetic heart valves are crucial for patients with valvular heart disease.
- Assessing prosthetic valve function is vital for patient management.
- Transesophageal echocardiography (TEE) is a key imaging modality.
Purpose of the Study:
- To report the experience of the Echocardiography Department at the National Institute of Cardiology Ignacio Chávez.
- To evaluate the effectiveness of TEE in diagnosing prosthetic valve dysfunction.
- To analyze the types and causes of dysfunction in mechanical and bioprosthetic valves.
Main Methods:
- A retrospective study of 60 patients with 75 prosthetic valves (19 bioprosthetic, 56 mechanical).
- Valves were located in mitral, aortic, and tricuspid positions.
- Transesophageal echocardiography was performed using 5 MHz monoplane or biplane transducers.
Main Results:
- 52% of prosthetic valves functioned normally.
- 48% of prosthetic valves exhibited signs of dysfunction.
- Common dysfunctions included obstruction, pannus, endocarditis, and periprosthetic leaks for mechanical valves; leaflet rupture, stenosis, calcification, dehiscence, endocarditis, and leaks for bioprostheses.
Conclusions:
- The findings align with existing literature on prosthetic valve dysfunction.
- TEE is highly valuable for detecting and characterizing valvular prosthetic dysfunction.
- This experience highlights the importance of TEE in cardiology practice.
Abstract:
The aim of this paper is to inform about the experience of the Echocardiography Department of the National Institute of Cardiology Ignacio Chávez, in the assessment of prosthetic valves dysfunction by transesophageal echocardiography. Sixty patients with a total of 75 prosthetic valves: 19 bioprostheses and 56 mechanical valves were studied. Forty four were in mitral position, 27 in aortic position and 4 in tricuspid position. All patients were evaluated using 5 MHz monoplane or biplane transesophageal transducers. The 52% (39) of the studied prosthetic valves were found normally functioning. However, 48% (36) of these showed signs of dysfunction. The causes of dysfunction in the mechanical valves were: obstruction, pannus, infectious endocarditis and periprosthetic leak, and in relation with bioprostheses rupture of the leaflets, stenosis and calcification, partial dehiscence, infectious endocarditis and periprosthetic leak were identified. The obtained percentage and type of prosthetic valves dysfunction in our results agree with those reported in the literature and confirm the great utility of transesophageal research in the detection of the valvular prosthetic dysfunction.