Doppler haemodynamic profiles of clinically and echocardiographically normal mitral and aortic valve prostheses.
Doppler echocardiographic studies were performed in 380 consecutive patients with 415 normally functioning artificial valves to establish normal Doppler characteristics for each type of prostheses used in our institution, with particular reference to Starr-Edwards valves, and to serve as control studies for future assessment. None of the patients were in heart failure at the time of the study. Peak transaortic velocities (m.s-1) were higher and effective orifice areas (cm2) smaller in mechanical valves as a whole, when compared with bioprostheses (P less than 0.01); 2.7 +/- 0.7 and 1.4 +/- 0.55 for Starr-Edwards, 2.7 +/- 0.6 and 1.5 +/- 0.6 for Bjork-Shiley, 1.8 +/- 0.1 and 1.5 +/- 0.6 for Duromedics and 1.5 +/- 0.06 and 2 +/- 0.12 for bioprostheses, respectively. In the mitral position, the average peak diastolic velocities (m. s-1) and pressure half-times (ms) were higher in mechanical valves, but there was a large overlap between the various types and sizes of prostheses (P = NS); 1.6 +/- 0.3 and 98 +/- 25 for Starr-Edwards, 1.4 +/- 0.3 and 88 +/- 26 for Bjork-Shiley, 1.8 +/- 0.1 and 75 +/- 5 for Duromedics and 1.5 +/- 0.3 and 90 +/- 20 for bioprostheses, respectively. There was an inverse relation between valve size and pressure halftime for Starr-Edwards prostheses (P less than 0.01). Doppler flow characteristics in mechanical valves where similar in patients with normal and dysfunctioning prostheses. Valvular or myocardial dysfunction could best be ascertained when early postoperative studies were available for comparison.(ABSTRACT TRUNCATED AT 250 WORDS)
Nihoyannopoulos
P
P
Department of Medicine, Hammersmith Hospital, R.P.M.S., London, U.K.
Kambouroglou
D
D
Athanassopoulos
G
G
Nadazdin
A
A
Smith
P
P
Oakley
C M
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001705:Bioprosthesis; D001783:Blood Flow Velocity; D001794:Blood Pressure; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure