ABSTRACT
We describe two patients in whom mitral valve prosthetic inflow mimicked severe aortic regurgitation. Repeat transthoracic echocardiography using multiple transducer angulations and a narrow color Doppler sector angle in one patient and a color Doppler M-Mode study in the second patient proved useful in excluding the presence of severe aortic regurgitation.
Subject(s)
Aortic Valve Insufficiency/diagnostic imaging , Echocardiography, Doppler, Color/methods , Heart Valve Prosthesis , Mitral Valve/diagnostic imaging , Adult , Diagnosis, Differential , Female , Humans , MaleABSTRACT
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.
