Evaluation of Björk-Shiley prosthetic valves by real-time two-dimensional Doppler echocardiographic flow mapping

Howard Dittrich, Pascal Nicod, Brian Hoit, Nancy Dalton, David Sahn

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

We studied the value of two-dimensional Doppler echocardiographic color flow mapping for identifying normal transvalve flow profiles and valve malfunction in 20 patients with Björk-Shiley prosthetic valves. Seven patients had Björk-Shiley prosthetic valves in the aortic position alone, seven in the mitral position, and six had prosthetic valves in both the aortic and mitral positions. In 10 patients with normally functioning mitral valves, the ratios of the maximal major and minor Doppler-imaged orifice flow diameters to the valve ring diameters were 25 ± 3% (mean ± SD) and 24 ± 3%, respectively, similar to values reported in in vitro studies. No mitral regurgitation was found in these patients by two-dimensional Doppler echocardiographic flow mapping or by spectral Doppler. Of the 10 clinically normal aortic Björk-Shiley valves, no valvular regurgitation was found by color flow mapping, whereas mild aortic regurgitation was found in two patients with the use of spectral Doppler. Malfunction of six valves was documented in five patients and was confirmed by cardiac catheterization and/or surgery. These included one case of focal fibrous ingrowth involving primarily the minor orifice of a mitral prosthetic valve, one case of mitral valve prosthetic thrombosis with decreased major and minor orifice flow diameters and valvular regurgitation, and four cases of paravalvular regurgitation involving prosthetic valves in the aortic position (three patients) and the mitral position (one patient). Two-dimensional Doppler echocardiographic flow mapping provides new observations that may aid in identifying Björk-Shiley prosthetic valve malfunction. By localizing precisely the site of prosthetic stenosis or regurgitation, it may also assist in defining the cause of valve malfunction.

Original languageEnglish (US)
Pages (from-to)133-138
Number of pages6
JournalAmerican Heart Journal
Volume115
Issue number1 PART 1
DOIs
StatePublished - 1988
Externally publishedYes

Fingerprint

Mitral Valve
Aortic Valve
Color
Aortic Valve Insufficiency
Mitral Valve Insufficiency
Cardiac Catheterization
Thoracic Surgery
Pathologic Constriction
Thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of Björk-Shiley prosthetic valves by real-time two-dimensional Doppler echocardiographic flow mapping. / Dittrich, Howard; Nicod, Pascal; Hoit, Brian; Dalton, Nancy; Sahn, David.

In: American Heart Journal, Vol. 115, No. 1 PART 1, 1988, p. 133-138.

Research output: Contribution to journalArticle

Dittrich, Howard ; Nicod, Pascal ; Hoit, Brian ; Dalton, Nancy ; Sahn, David. / Evaluation of Björk-Shiley prosthetic valves by real-time two-dimensional Doppler echocardiographic flow mapping. In: American Heart Journal. 1988 ; Vol. 115, No. 1 PART 1. pp. 133-138.
@article{38cc0a7073e741168ea097dfb73311fc,
title = "Evaluation of Bj{\"o}rk-Shiley prosthetic valves by real-time two-dimensional Doppler echocardiographic flow mapping",
abstract = "We studied the value of two-dimensional Doppler echocardiographic color flow mapping for identifying normal transvalve flow profiles and valve malfunction in 20 patients with Bj{\"o}rk-Shiley prosthetic valves. Seven patients had Bj{\"o}rk-Shiley prosthetic valves in the aortic position alone, seven in the mitral position, and six had prosthetic valves in both the aortic and mitral positions. In 10 patients with normally functioning mitral valves, the ratios of the maximal major and minor Doppler-imaged orifice flow diameters to the valve ring diameters were 25 ± 3{\%} (mean ± SD) and 24 ± 3{\%}, respectively, similar to values reported in in vitro studies. No mitral regurgitation was found in these patients by two-dimensional Doppler echocardiographic flow mapping or by spectral Doppler. Of the 10 clinically normal aortic Bj{\"o}rk-Shiley valves, no valvular regurgitation was found by color flow mapping, whereas mild aortic regurgitation was found in two patients with the use of spectral Doppler. Malfunction of six valves was documented in five patients and was confirmed by cardiac catheterization and/or surgery. These included one case of focal fibrous ingrowth involving primarily the minor orifice of a mitral prosthetic valve, one case of mitral valve prosthetic thrombosis with decreased major and minor orifice flow diameters and valvular regurgitation, and four cases of paravalvular regurgitation involving prosthetic valves in the aortic position (three patients) and the mitral position (one patient). Two-dimensional Doppler echocardiographic flow mapping provides new observations that may aid in identifying Bj{\"o}rk-Shiley prosthetic valve malfunction. By localizing precisely the site of prosthetic stenosis or regurgitation, it may also assist in defining the cause of valve malfunction.",
author = "Howard Dittrich and Pascal Nicod and Brian Hoit and Nancy Dalton and David Sahn",
year = "1988",
doi = "10.1016/0002-8703(88)90528-5",
language = "English (US)",
volume = "115",
pages = "133--138",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "1 PART 1",

}

TY - JOUR

T1 - Evaluation of Björk-Shiley prosthetic valves by real-time two-dimensional Doppler echocardiographic flow mapping

AU - Dittrich, Howard

AU - Nicod, Pascal

AU - Hoit, Brian

AU - Dalton, Nancy

AU - Sahn, David

PY - 1988

Y1 - 1988

N2 - We studied the value of two-dimensional Doppler echocardiographic color flow mapping for identifying normal transvalve flow profiles and valve malfunction in 20 patients with Björk-Shiley prosthetic valves. Seven patients had Björk-Shiley prosthetic valves in the aortic position alone, seven in the mitral position, and six had prosthetic valves in both the aortic and mitral positions. In 10 patients with normally functioning mitral valves, the ratios of the maximal major and minor Doppler-imaged orifice flow diameters to the valve ring diameters were 25 ± 3% (mean ± SD) and 24 ± 3%, respectively, similar to values reported in in vitro studies. No mitral regurgitation was found in these patients by two-dimensional Doppler echocardiographic flow mapping or by spectral Doppler. Of the 10 clinically normal aortic Björk-Shiley valves, no valvular regurgitation was found by color flow mapping, whereas mild aortic regurgitation was found in two patients with the use of spectral Doppler. Malfunction of six valves was documented in five patients and was confirmed by cardiac catheterization and/or surgery. These included one case of focal fibrous ingrowth involving primarily the minor orifice of a mitral prosthetic valve, one case of mitral valve prosthetic thrombosis with decreased major and minor orifice flow diameters and valvular regurgitation, and four cases of paravalvular regurgitation involving prosthetic valves in the aortic position (three patients) and the mitral position (one patient). Two-dimensional Doppler echocardiographic flow mapping provides new observations that may aid in identifying Björk-Shiley prosthetic valve malfunction. By localizing precisely the site of prosthetic stenosis or regurgitation, it may also assist in defining the cause of valve malfunction.

AB - We studied the value of two-dimensional Doppler echocardiographic color flow mapping for identifying normal transvalve flow profiles and valve malfunction in 20 patients with Björk-Shiley prosthetic valves. Seven patients had Björk-Shiley prosthetic valves in the aortic position alone, seven in the mitral position, and six had prosthetic valves in both the aortic and mitral positions. In 10 patients with normally functioning mitral valves, the ratios of the maximal major and minor Doppler-imaged orifice flow diameters to the valve ring diameters were 25 ± 3% (mean ± SD) and 24 ± 3%, respectively, similar to values reported in in vitro studies. No mitral regurgitation was found in these patients by two-dimensional Doppler echocardiographic flow mapping or by spectral Doppler. Of the 10 clinically normal aortic Björk-Shiley valves, no valvular regurgitation was found by color flow mapping, whereas mild aortic regurgitation was found in two patients with the use of spectral Doppler. Malfunction of six valves was documented in five patients and was confirmed by cardiac catheterization and/or surgery. These included one case of focal fibrous ingrowth involving primarily the minor orifice of a mitral prosthetic valve, one case of mitral valve prosthetic thrombosis with decreased major and minor orifice flow diameters and valvular regurgitation, and four cases of paravalvular regurgitation involving prosthetic valves in the aortic position (three patients) and the mitral position (one patient). Two-dimensional Doppler echocardiographic flow mapping provides new observations that may aid in identifying Björk-Shiley prosthetic valve malfunction. By localizing precisely the site of prosthetic stenosis or regurgitation, it may also assist in defining the cause of valve malfunction.

UR - http://www.scopus.com/inward/record.url?scp=0023708782&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023708782&partnerID=8YFLogxK

U2 - 10.1016/0002-8703(88)90528-5

DO - 10.1016/0002-8703(88)90528-5

M3 - Article

C2 - 3336968

AN - SCOPUS:0023708782

VL - 115

SP - 133

EP - 138

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 1 PART 1

ER -