Echocardiographic Assessment of Prosthetic Heart Valves

Lori A. Blauwet, Fletcher A Jr. Miller

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Valvular heart disease is a global health problem. It is estimated that more than 280,000 prosthetic heart valves are implanted worldwide each year. As the world's population is aging, the incidence of prosthetic heart valve implantation and the prevalence of prosthetic heart valves continue to increase. Assessing heart valve prosthesis function remains challenging, as prosthesis malfunction is unpredictable but not uncommon.Transthoracic two-dimensional and Doppler echocardiography is the preferred method for assessing prosthetic valve function. Clinically useful Doppler-derived measures for assessing prosthetic valve hemodynamic profiles have been reported for aortic, mitral, and tricuspid valve prostheses, but echocardiographic data regarding pulmonary valve prostheses remain limited. Complete prosthetic valve evaluation by transthoracic echocardiography (TTE) is sometimes challenging due to acoustic shadowing and artifacts. In these cases, further imaging with transesophageal echocardiography, fluoroscopy and/or gated CT may be warranted, particularly if prosthetic valve dysfunction is suspected. Being able to differentiate pathologic versus functional obstruction of an individual prosthesis is extremely important, as this distinction affects management decisions. Transprosthetic and periprosthetic regurgitation may be difficult to visualize on TTE, so careful review of Doppler-derived data combined with a high index of suspicion is warranted, particularly in symptomatic patients. A baseline TTE soon after valve implantation is indicated in order to "fingerprint" the prosthesis hemodynamic profile. It remains unclear how frequently serial imaging should be performed in order to assess prosthetic valve function, as this issue has not been systematically studied.

Original languageEnglish (US)
Pages (from-to)100-110
Number of pages11
JournalProgress in Cardiovascular Diseases
Volume57
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Heart Valves
Prostheses and Implants
Echocardiography
Hemodynamics
Heart Valve Prosthesis
Pulmonary Valve
Heart Valve Diseases
Tricuspid Valve
Doppler Echocardiography
Fluoroscopy
Transesophageal Echocardiography
Dermatoglyphics
Aortic Valve
Mitral Valve
Acoustics
Artifacts
Incidence
Population

Keywords

  • Doppler
  • Echocardiography
  • Heart valves
  • Prosthesis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Echocardiographic Assessment of Prosthetic Heart Valves. / Blauwet, Lori A.; Miller, Fletcher A Jr.

In: Progress in Cardiovascular Diseases, Vol. 57, No. 1, 2014, p. 100-110.

Research output: Contribution to journalArticle

@article{c6f9927ca0284e7b8d04ca7a68aac071,
title = "Echocardiographic Assessment of Prosthetic Heart Valves",
abstract = "Valvular heart disease is a global health problem. It is estimated that more than 280,000 prosthetic heart valves are implanted worldwide each year. As the world's population is aging, the incidence of prosthetic heart valve implantation and the prevalence of prosthetic heart valves continue to increase. Assessing heart valve prosthesis function remains challenging, as prosthesis malfunction is unpredictable but not uncommon.Transthoracic two-dimensional and Doppler echocardiography is the preferred method for assessing prosthetic valve function. Clinically useful Doppler-derived measures for assessing prosthetic valve hemodynamic profiles have been reported for aortic, mitral, and tricuspid valve prostheses, but echocardiographic data regarding pulmonary valve prostheses remain limited. Complete prosthetic valve evaluation by transthoracic echocardiography (TTE) is sometimes challenging due to acoustic shadowing and artifacts. In these cases, further imaging with transesophageal echocardiography, fluoroscopy and/or gated CT may be warranted, particularly if prosthetic valve dysfunction is suspected. Being able to differentiate pathologic versus functional obstruction of an individual prosthesis is extremely important, as this distinction affects management decisions. Transprosthetic and periprosthetic regurgitation may be difficult to visualize on TTE, so careful review of Doppler-derived data combined with a high index of suspicion is warranted, particularly in symptomatic patients. A baseline TTE soon after valve implantation is indicated in order to {"}fingerprint{"} the prosthesis hemodynamic profile. It remains unclear how frequently serial imaging should be performed in order to assess prosthetic valve function, as this issue has not been systematically studied.",
keywords = "Doppler, Echocardiography, Heart valves, Prosthesis",
author = "Blauwet, {Lori A.} and Miller, {Fletcher A Jr.}",
year = "2014",
doi = "10.1016/j.pcad.2014.05.001",
language = "English (US)",
volume = "57",
pages = "100--110",
journal = "Progress in Cardiovascular Diseases",
issn = "0033-0620",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Echocardiographic Assessment of Prosthetic Heart Valves

AU - Blauwet, Lori A.

AU - Miller, Fletcher A Jr.

PY - 2014

Y1 - 2014

N2 - Valvular heart disease is a global health problem. It is estimated that more than 280,000 prosthetic heart valves are implanted worldwide each year. As the world's population is aging, the incidence of prosthetic heart valve implantation and the prevalence of prosthetic heart valves continue to increase. Assessing heart valve prosthesis function remains challenging, as prosthesis malfunction is unpredictable but not uncommon.Transthoracic two-dimensional and Doppler echocardiography is the preferred method for assessing prosthetic valve function. Clinically useful Doppler-derived measures for assessing prosthetic valve hemodynamic profiles have been reported for aortic, mitral, and tricuspid valve prostheses, but echocardiographic data regarding pulmonary valve prostheses remain limited. Complete prosthetic valve evaluation by transthoracic echocardiography (TTE) is sometimes challenging due to acoustic shadowing and artifacts. In these cases, further imaging with transesophageal echocardiography, fluoroscopy and/or gated CT may be warranted, particularly if prosthetic valve dysfunction is suspected. Being able to differentiate pathologic versus functional obstruction of an individual prosthesis is extremely important, as this distinction affects management decisions. Transprosthetic and periprosthetic regurgitation may be difficult to visualize on TTE, so careful review of Doppler-derived data combined with a high index of suspicion is warranted, particularly in symptomatic patients. A baseline TTE soon after valve implantation is indicated in order to "fingerprint" the prosthesis hemodynamic profile. It remains unclear how frequently serial imaging should be performed in order to assess prosthetic valve function, as this issue has not been systematically studied.

AB - Valvular heart disease is a global health problem. It is estimated that more than 280,000 prosthetic heart valves are implanted worldwide each year. As the world's population is aging, the incidence of prosthetic heart valve implantation and the prevalence of prosthetic heart valves continue to increase. Assessing heart valve prosthesis function remains challenging, as prosthesis malfunction is unpredictable but not uncommon.Transthoracic two-dimensional and Doppler echocardiography is the preferred method for assessing prosthetic valve function. Clinically useful Doppler-derived measures for assessing prosthetic valve hemodynamic profiles have been reported for aortic, mitral, and tricuspid valve prostheses, but echocardiographic data regarding pulmonary valve prostheses remain limited. Complete prosthetic valve evaluation by transthoracic echocardiography (TTE) is sometimes challenging due to acoustic shadowing and artifacts. In these cases, further imaging with transesophageal echocardiography, fluoroscopy and/or gated CT may be warranted, particularly if prosthetic valve dysfunction is suspected. Being able to differentiate pathologic versus functional obstruction of an individual prosthesis is extremely important, as this distinction affects management decisions. Transprosthetic and periprosthetic regurgitation may be difficult to visualize on TTE, so careful review of Doppler-derived data combined with a high index of suspicion is warranted, particularly in symptomatic patients. A baseline TTE soon after valve implantation is indicated in order to "fingerprint" the prosthesis hemodynamic profile. It remains unclear how frequently serial imaging should be performed in order to assess prosthetic valve function, as this issue has not been systematically studied.

KW - Doppler

KW - Echocardiography

KW - Heart valves

KW - Prosthesis

UR - http://www.scopus.com/inward/record.url?scp=84904911894&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904911894&partnerID=8YFLogxK

U2 - 10.1016/j.pcad.2014.05.001

DO - 10.1016/j.pcad.2014.05.001

M3 - Article

C2 - 25081405

AN - SCOPUS:84904911894

VL - 57

SP - 100

EP - 110

JO - Progress in Cardiovascular Diseases

JF - Progress in Cardiovascular Diseases

SN - 0033-0620

IS - 1

ER -