Comprehensive echocardiographic assessment of the hemodynamic parameters of 285 tricuspid valve bioprostheses early after implantation

Lori A. Blauwet, Gordon K. Danielson, Harold M. Burkhart, Joseph A. Dearani, Joseph F. Malouf, Heidi M. Connolly, David O. Hodge, Regina M. Herges, Fletcher A Jr. Miller

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Doppler-derived hemodynamic data for normal tricuspid valve bioprostheses are limited. Methods: A comprehensive retrospective Doppler echocardiographic assessment of 285 normal Carpentier-Edwards Duraflex, Medtronic Mosaic, St. Jude Medical Biocor, Carpentier-Edwards Perimount, and Medtronic Hancock II tricuspid valve bioprostheses was performed early after implantation. All the important Doppler-derived hemodynamic variables reported to date for mitral valve prostheses were used. Mean values for hemodynamic variables were obtained by averaging measurements of five and nine consecutive cardiac cycles. Results: No clinically significant difference was found in the mean values obtained for the Doppler parameters when measurements were averaged from five or nine consecutive cardiac cycles. The mean value for the mean gradient was 5.2 mm Hg. Regardless of valve type and body surface area, pressure half-time was <200 msec for all 76 patients in whom it could be measured. Mean gradient <9 mm Hg, E velocity <2.1 m/sec, time-velocity integral of the tricuspid valve prosthesis <66 cm, and ratio of the time-velocity integral of the tricuspid valve prosthesis to the time-velocity integral of the left ventricular outflow tract <3.3 were recorded in 254 of the 285 patients (89%). Conclusions: This study establishes parameters for Doppler-derived hemodynamic data for various types of normal tricuspid valve bioprostheses. These threshold values (mean + 2 standard deviations) are specific, but not sensitive, for identifying tricuspid valve bioprosthesis dysfunction. Prostheses with hemodynamic values that are higher than these threshold values are likely dysfunctional, but in select cases, tricuspid valve bioprosthesis dysfunction may be present even when hemodynamic values are lower than these thresholds.

Original languageEnglish (US)
JournalJournal of the American Society of Echocardiography
Volume23
Issue number10
DOIs
StatePublished - Oct 2010

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Bioprosthesis
Tricuspid Valve
Hemodynamics
Prostheses and Implants
Body Surface Area
Mitral Valve
Pressure

Keywords

  • Doppler
  • Echocardiography
  • Prosthesis
  • Tricuspid

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Comprehensive echocardiographic assessment of the hemodynamic parameters of 285 tricuspid valve bioprostheses early after implantation. / Blauwet, Lori A.; Danielson, Gordon K.; Burkhart, Harold M.; Dearani, Joseph A.; Malouf, Joseph F.; Connolly, Heidi M.; Hodge, David O.; Herges, Regina M.; Miller, Fletcher A Jr.

In: Journal of the American Society of Echocardiography, Vol. 23, No. 10, 10.2010.

Research output: Contribution to journalArticle

Blauwet, Lori A. ; Danielson, Gordon K. ; Burkhart, Harold M. ; Dearani, Joseph A. ; Malouf, Joseph F. ; Connolly, Heidi M. ; Hodge, David O. ; Herges, Regina M. ; Miller, Fletcher A Jr. / Comprehensive echocardiographic assessment of the hemodynamic parameters of 285 tricuspid valve bioprostheses early after implantation. In: Journal of the American Society of Echocardiography. 2010 ; Vol. 23, No. 10.
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abstract = "Background: Doppler-derived hemodynamic data for normal tricuspid valve bioprostheses are limited. Methods: A comprehensive retrospective Doppler echocardiographic assessment of 285 normal Carpentier-Edwards Duraflex, Medtronic Mosaic, St. Jude Medical Biocor, Carpentier-Edwards Perimount, and Medtronic Hancock II tricuspid valve bioprostheses was performed early after implantation. All the important Doppler-derived hemodynamic variables reported to date for mitral valve prostheses were used. Mean values for hemodynamic variables were obtained by averaging measurements of five and nine consecutive cardiac cycles. Results: No clinically significant difference was found in the mean values obtained for the Doppler parameters when measurements were averaged from five or nine consecutive cardiac cycles. The mean value for the mean gradient was 5.2 mm Hg. Regardless of valve type and body surface area, pressure half-time was <200 msec for all 76 patients in whom it could be measured. Mean gradient <9 mm Hg, E velocity <2.1 m/sec, time-velocity integral of the tricuspid valve prosthesis <66 cm, and ratio of the time-velocity integral of the tricuspid valve prosthesis to the time-velocity integral of the left ventricular outflow tract <3.3 were recorded in 254 of the 285 patients (89{\%}). Conclusions: This study establishes parameters for Doppler-derived hemodynamic data for various types of normal tricuspid valve bioprostheses. These threshold values (mean + 2 standard deviations) are specific, but not sensitive, for identifying tricuspid valve bioprosthesis dysfunction. Prostheses with hemodynamic values that are higher than these threshold values are likely dysfunctional, but in select cases, tricuspid valve bioprosthesis dysfunction may be present even when hemodynamic values are lower than these thresholds.",
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AU - Danielson, Gordon K.

AU - Burkhart, Harold M.

AU - Dearani, Joseph A.

AU - Malouf, Joseph F.

AU - Connolly, Heidi M.

AU - Hodge, David O.

AU - Herges, Regina M.

AU - Miller, Fletcher A Jr.

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AB - Background: Doppler-derived hemodynamic data for normal tricuspid valve bioprostheses are limited. Methods: A comprehensive retrospective Doppler echocardiographic assessment of 285 normal Carpentier-Edwards Duraflex, Medtronic Mosaic, St. Jude Medical Biocor, Carpentier-Edwards Perimount, and Medtronic Hancock II tricuspid valve bioprostheses was performed early after implantation. All the important Doppler-derived hemodynamic variables reported to date for mitral valve prostheses were used. Mean values for hemodynamic variables were obtained by averaging measurements of five and nine consecutive cardiac cycles. Results: No clinically significant difference was found in the mean values obtained for the Doppler parameters when measurements were averaged from five or nine consecutive cardiac cycles. The mean value for the mean gradient was 5.2 mm Hg. Regardless of valve type and body surface area, pressure half-time was <200 msec for all 76 patients in whom it could be measured. Mean gradient <9 mm Hg, E velocity <2.1 m/sec, time-velocity integral of the tricuspid valve prosthesis <66 cm, and ratio of the time-velocity integral of the tricuspid valve prosthesis to the time-velocity integral of the left ventricular outflow tract <3.3 were recorded in 254 of the 285 patients (89%). Conclusions: This study establishes parameters for Doppler-derived hemodynamic data for various types of normal tricuspid valve bioprostheses. These threshold values (mean + 2 standard deviations) are specific, but not sensitive, for identifying tricuspid valve bioprosthesis dysfunction. Prostheses with hemodynamic values that are higher than these threshold values are likely dysfunctional, but in select cases, tricuspid valve bioprosthesis dysfunction may be present even when hemodynamic values are lower than these thresholds.

KW - Doppler

KW - Echocardiography

KW - Prosthesis

KW - Tricuspid

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