Doppler color flow mapping in the evaluation of prosthetic mitral and aortic valve function.
Doppler color flow mapping and color-guided conventional Doppler studies were performed on 119 patients with 126 prosthetic valves (mitral alone in 60, aortic alone in 52 and both mitral and aortic in 7 patients) within 2 weeks of the catheterization study or surgery, or both. The mean pressure gradients derived by color-guided continuous wave Doppler ultrasound correlated well with those obtained at catheterization for both the tissue and mechanical mitral and aortic prostheses (r = 0.85 to 0.87). For the effective prosthetic orifice areas, better correlation with catheterization results were obtained with the tissue mitral (r = 0.94) and tissue aortic (r = 0.87) prostheses than with the mechanical mitral (r = 0.79) and mechanical aortic (r = 0.76) prostheses. The maximal width of the color flow signals at their origin from the tissue mitral prostheses also correlated well with the effective prosthetic orifice area at catheterization (r = 0.81). Doppler color flow mapping identified prosthetic valvular regurgitation with a sensitivity and specificity of 89% and 100%, respectively, for the mitral and 92% and 83% for the aortic prostheses. There was complete agreement between the Doppler color flow mapping and angiographic grading of the severity of prosthetic valvular regurgitation in 90% of mitral and 73.5% of the aortic regurgitant prostheses with under- or overestimation by greater than 1 grade in only two cases. Valvular and paravalvular regurgitation was correctly categorized by Doppler color flow mapping in relation to the surgical findings in 94% of the mitral and 80.5% of the aortic prostheses.
Kapur
K K
KK
Division of Cardiovascular Disease, University of Alabama, Birmingham 35294.
Fan
P
P
Nanda
N C
NC
Yoganathan
A P
AP
Goyal
R G
RG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D003326:Coronary Circulation; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D014463:Ultrasonography / Q000379:methods*