Non-invasive assessment of differences between bileaflet and tilting-disc aortic valve prostheses by 3D-Doppler profiles.
The aim of this study was to analyse flow characteristics of two different prosthetic valves by means of a non-invasive 3D Doppler technique. As previously demonstrated, negative velocity peaks within a 3D-Doppler profile significantly correlate with the severity of aortic stenosis. Transesophageal echocardiography was performed in 42 patients with normal aortic valves and in 35 patients after aortic valve replacement (bileaflet n=23, tilting-disc n=12). Three-dimensional reconstruction of color Doppler data was performed by the EchoAnalyzer software developed at our institution. Cross-section velocity distribution in the ascending aorta was analysed 2 cm distal to the aortic valve in 3 different sectors (non-coronary (NC), left-coronary (LC) or right-coronary (RC)). The percentages of negative velocity values (PNVV) in native aortic valves (6.8+/-6.4%, range: 0-21.8%) were significantly lower (P<0.0001) than in prosthetic valves (bileaflet: 38.5+/-18.5%, range: 13.2-71%; tilting-disc: 47.2+/-17.6%, range: 21.7-78.1%). Significant differences between normal and prosthetic valves were found in all different sectors. Furthermore, Medtronic Hall showed significantly higher PNVV than St. Jude Medical within the LC sector (P=0.03). This method, which allows non-invasive analysis of 3D flow distributions in patients, revealed significant differences between prosthetic valves and native valves as well as among different prosthetic types.
University of Heidelberg Cardiac Surgery, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany. Sibylle_Link@med.uni-heidelberg.de
Sibylle
S
Mottl-Link
Ivo
I
Wolf
Mark
M
Hastenteufel
Steffen
S
Witte
Hans-Peter
HP
Meinzer
Siegfried
S
Hagl
Raffaele
R
De Simone