title: Doppler echocardiographic evaluation of St. Jude Medical valves in the tricuspid position: criteria for normal and abnormal valve function.
abstract: BACKGROUND
  Although this examination for mitral and aortic prosthetic valves has been frequently reported to be available for the early diagnosis of complications, there are few reports on examinations for tricuspid prosthetic valves, particularly the mechanical valve such as the St. Jude Medical (SJM) valve. Furthermore, the criteria for early diagnosis of complications are unknown. The purpose of this study is to evaluate the SJM valve in the tricuspid position by Doppler echocardiography and to analyze valve-related complications.
  
  
  METHODS
  Between September 1978 and March 1997, 46 patients underwent tricuspid valve replacements with SJM valves; these cases were evaluated by Doppler echocardiography. We divided the cases into Normal and Complication groups.
  
  
  RESULTS
  In the Normal group, peak pressure gradient was 4.2+/-1.5 mmHg and pressure half-time was 123.5+/-22.9 msec. In the Complication group, peak pressure gradient was 12.7+/-3.6 mmHg and pressure half-time was 271.8+/-76.4 msec. In the Complication group, the lowest peak pressure gradient case was 8.0 mmHg and the shortest pressure half-time was 160.0 msec.
  
  
  CONCLUSIONS
  We concluded that when the peak pressure gradient is more than 8 mmHg or the pressure half-time is more than 160 msec, there is a possibility of complications. Despite the problems, the absence of any structural change after more than ten years suggests that the SJM valve can be used in the tricuspid position with careful follow-up.
authors.affiliation: Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Sezai
authors.forename: M
authors.initials: M
authors.lastname: Shiono
authors.forename: K
authors.initials: K
authors.lastname: Akiyama
authors.forename: Y
authors.initials: Y
authors.lastname: Orime
authors.forename: H
authors.initials: H
authors.lastname: Hata
authors.forename: S
authors.initials: S
authors.lastname: Yagi
authors.forename: S
authors.initials: S
authors.lastname: Tsukamoto
authors.forename: K
authors.initials: K
authors.lastname: Nakata
authors.forename: M
authors.initials: M
authors.lastname: Hata
authors.forename: N
authors.initials: N
authors.lastname: Negishi
authors.forename: Y
authors.initials: Y
authors.lastname: Sezai
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D015150:Echocardiography, Doppler; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000601:surgery*