title: Hemodynamic evaluation of normally functioning Sulzer Carbomedics prosthetic valves.
abstract: The Sulzer Carbomedics prosthetic heart valve (CP) is a commonly used mechanical valve in clinical practice. In the present study, we used conventional and color Doppler echocardiography to assess the hemodynamics of normally functioning CP in the aortic (n = 73) and mitral (n = 127) positions. Our findings demonstrate no significant correlation of Doppler-measured peak and mean pressure gradients and effective orifice area with implanted valve size and actual orifice areas, measured directly by the manufacturer for CPs in both the mitral and aortic positions. However, it is still useful to measure effective orifice area by Doppler because a value in the normal or nonstenotic range points to an unobstructed prosthesis in the aortic or mitral position, in the absence of poor left ventricular ejection fraction. A value in the stenotic range could mean a normally functioning or obstructed prosthesis and, therefore, may need further investigation, such as assessment of valve leaflet motion by transthoracic or transesophageal echocardiography or fluoroscopy. Valve regurgitation as evaluated by color Doppler flow mapping was mild in practically all CPs in the aortic position, and in the majority of CPs in the mitral position.
authors.affiliation: Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Nurgül
authors.initials: N
authors.lastname: Keser
authors.forename: Navin C
authors.initials: NC
authors.lastname: Nanda
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Miller
authors.forename: Szilard
authors.initials: S
authors.lastname: Voros
authors.forename: Cahide
authors.initials: C
authors.lastname: Soydas
authors.forename: Gopal
authors.initials: G
authors.lastname: Agrawal
authors.forename: Chiara
authors.initials: C
authors.lastname: Liguori
authors.forename: David
authors.initials: D
authors.lastname: Naftel
authors.forename: Albert D
authors.initials: AD
authors.lastname: Pacifico
authors.forename: James K
authors.initials: JK
authors.lastname: Kirklin
authors.forename: David C
authors.initials: DC
authors.lastname: McGiffin
authors.forename: William L
authors.initials: WL
authors.lastname: Holman
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D001794:Blood Pressure; D018618:Echocardiography, Doppler, Color / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology; D011475:Prosthesis Failure