title: [Echocardiographic diagnosis of obstructive intermittent dysfunction of a mitral disc prosthetic valve].
abstract: Echocardiographic findings in six patients with obstructive intermittent dysfunction of mechanical disc prosthetic mitral valve (OIPD) are described. All with a clinical picture of gradual installation and progressive dyspnea of several weeks of evolution. TTE with Bd recordings were performed in all of them with "oriented" M mode from apical 4/C view. The findings were compared with a control group of 14 patients with normal prosthetic valves. In the group of OIDP, all patients displayed a variable delay in the opening of the prosthetic disc, registered as a "protodiastolic step" in M mode. In three patients, the dysfunction was due to a thrombus. In two, due to pannus. Three were operated. One with thrombolysis. In two, the treatment consisted of heparin and increased oral anticoagulation. None die during the acute handling of the intermittent dysfunction. Two patients died: one seven months later due to cardiac failure and the other a year later due to prosthetic rethrombosis. In patients with mechanical prosthetic valve in mitral valve position and progressive dyspnea, the presence of a variable delay in the opening of the prosthesis is diagnostic of OIDP and requires urgent handling with thrombolysis or surgery.
authors.affiliation: Departamento de Ecocardiografía, Instituto Nacional de Cardiologia lgnacio Chavez, Tlalpan, México. anromeroca@yahoo.com
authors.forename: Angel
authors.initials: A
authors.lastname: Romero Cárdenas
authors.forename: José León
authors.initials: JL
authors.lastname: Victoria Campos
authors.forename: M Guadalupe
authors.initials: MG
authors.lastname: Franco Zaragoza
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Roldán Gómez
authors.forename: Jesús
authors.initials: J
authors.lastname: Vargas Barrón
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D011475:Prosthesis Failure