Types of prosthetic valves
Type of valve
|
Structure
|
Mechanical
| |
Starr - Edwards
|
Ball and cage
|
Bjork-Shiley, Medtronic
|
Tilting disc
|
St Jude Medical, Carbomedics
|
Bileaflet
|
Bioprosthetic
| |
Carpentier - Edwards
|
Stented porcine
|
Baxter
|
Stented bovine
|
St Jude Toronto
|
Stentless
|
Physiological regurgitant jets are always through the valve orifice. A paravalvular or
perivalvular leak, though seen immediately after surgery is commonly pathological if
seen during routine scan. It may be difficult to accurately assess these, but their position
and size of the jet should be noted.
Measurements such as PISA etc will be difficult to perform. In particular, with mitral valve
jets, the normal regurgitant jet through the prosthetic valve may be difficult to see and
the more obvious jet is the paraprosthetic one. In aortic valves, it is good practice to describe
the position of the regurgitant jet in parasternal short axis using a ‘clock face’ analogy.
perivalvular leak, though seen immediately after surgery is commonly pathological if
seen during routine scan. It may be difficult to accurately assess these, but their position
and size of the jet should be noted.
Measurements such as PISA etc will be difficult to perform. In particular, with mitral valve
jets, the normal regurgitant jet through the prosthetic valve may be difficult to see and
the more obvious jet is the paraprosthetic one. In aortic valves, it is good practice to describe
the position of the regurgitant jet in parasternal short axis using a ‘clock face’ analogy.
Echo findings suggestive of prosthetic valve stenosis / obstruction (e.g. due to thrombus)
- Aortic valve - EOA < 1cm2 or fall in EOA of >30% since last scan
- Mitral valve - PHT >200ms and peak diastolic velocity >2.5m/s
- Tricuspid valve - peak diastolic velocity >1.5m/s
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