ECHO 2013 / Echocardiography for Assessment of Prosthetic Heart Valves

©2011 MFMER | slide-22

Example

EOA 0.6 cm2; MG = 30 mmHg

Possible Explanations

•Decreased LVEF

•Other reasons for low output (severe MR, severe TR, small LV)

•LVOT diameter measured too small

•LVOT TVI measured too small

Rules for Echo/Doppler Assessment of Aortic Prostheses

1.Perform CW Doppler from multiple positions

2.See the sewing ring before you measure the LVOT diameter

3.For the PW exam, go with the blue flow

4.Calculate SVI and compare to LVEF

5.Check for concordance between MG and

EOA

JASE 24 (9); September 2011

Flow Characteristics of the SAPIENTM aortic valve: the importance of recognizing in stent flow acceleration for the Echocardiographic assessment

of valve function

Shames S, Koczo A, Hahn R, Gillam L

JASE 24-B63; 2011

Flow Characteristics of the SAPIENTM aortic valve: the importance of recognizing in stent flow acceleration for the Echocardiographic assessment of valve function

•Use zoom view to position sample volume pre stent before activating Doppler

•Use diameter and TVI to calculate SVI while patient is still available for further imaging

•Measure and record in stent-pre valve velocity as surveillance for pre cusp stenosis

Mechanical Bileaflet Prostheses

In Vitro Pressure Recovery

Leaflets

Dist cath

30

Baumgartner H: Circulation 82(4), Oct 1990

CP1278638-4

©2011 MFMER | slide-29