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Valvar prosthetic dysfunction. Localisation and evaluation of the dysfunction using the Doppler technique

Thirty patients with 33 mitral or aortic prostheses or both were examined using the pulsed Doppler technique combined with cross sectional echocardiography to study the applicability of the Doppler technique in the diagnosis and evaluation of the severity of prosthetic dysfunction and to assess the... Full description

Journal Title: British Heart Journal 1985-09, Vol.54 (3), p.273-284
Main Author: Veyrat, C
Other Authors: Witchitz, S , Lessana, A , Ameur, A , Abitbol, G , Kalmanson, D
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
ID: ISSN: 0007-0769
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title: Valvar prosthetic dysfunction. Localisation and evaluation of the dysfunction using the Doppler technique
format: Article
creator:
  • Veyrat, C
  • Witchitz, S
  • Lessana, A
  • Ameur, A
  • Abitbol, G
  • Kalmanson, D
subjects:
  • Abridged Index Medicus
  • Aortic Valve - physiopathology
  • Aortic Valve Insufficiency - physiopathology
  • Aortic Valve Stenosis - physiopathology
  • Biological and medical sciences
  • Cardiology. Vascular system
  • cardiovascular system
  • Echocardiography
  • Endocardial and cardiac valvular diseases
  • Female
  • Heart
  • Heart Valve Diseases - physiopathology
  • Heart Valve Prosthesis
  • Humans
  • Male
  • Medical sciences
  • Middle Aged
  • Mitral Valve - physiopathology
  • Prosthesis Design
  • Research Article
  • Ultrasonography - methods
ispartof: British Heart Journal, 1985-09, Vol.54 (3), p.273-284
description: Thirty patients with 33 mitral or aortic prostheses or both were examined using the pulsed Doppler technique combined with cross sectional echocardiography to study the applicability of the Doppler technique in the diagnosis and evaluation of the severity of prosthetic dysfunction and to assess the ability of the mapping procedure to estimate the site and the size of the prosthetic defect. The dysfunction was valvar regurgitation in 29 instances and stenoses in eight, all of which were confirmed by invasive procedures. The severity of the dysfunction was graded on a three point scale. A control group of 73 subjects with 88 normal prostheses also underwent pulsed Doppler and cross sectional echocardiography. The pulsed Doppler study followed the usual procedure for a valvar disease including two and three dimensional mapping for regurgitation. Eight patients also underwent a continuous wave Doppler examination. The diagnostic reliability of the pulsed Doppler technique was greater than or equal to 90%. The severity of the dysfunction was accurately assessed in 86% of cases. In the case of aortic regurgitation, mapping of the jets was performed as easily for prostheses as for native regurgitant valves. In the case of mitral regurgitation, the mapping patterns depended on the cause of the dysfunction. With valvar tears, a jet was detected at the centre of the annulus, and with paravalvar leaks eccentric atrial jets were seen opposite the site of the leak. The pulsed Doppler and the surgical findings correlated well for both the site of the dysfunction (16/20 (80%) patients) and the size of the leak (13/16 (81%) patients). Thus, despite some limitations, pulsed Doppler and particularly the mapping procedure provide sufficient information to give an accurate non-invasive assessment of prosthetic valve dysfunction.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0007-0769
fulltext: fulltext
issn:
  • 0007-0769
  • 1355-6037
  • 1468-201X
  • 2053-5864
url: Link


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descriptionThirty patients with 33 mitral or aortic prostheses or both were examined using the pulsed Doppler technique combined with cross sectional echocardiography to study the applicability of the Doppler technique in the diagnosis and evaluation of the severity of prosthetic dysfunction and to assess the ability of the mapping procedure to estimate the site and the size of the prosthetic defect. The dysfunction was valvar regurgitation in 29 instances and stenoses in eight, all of which were confirmed by invasive procedures. The severity of the dysfunction was graded on a three point scale. A control group of 73 subjects with 88 normal prostheses also underwent pulsed Doppler and cross sectional echocardiography. The pulsed Doppler study followed the usual procedure for a valvar disease including two and three dimensional mapping for regurgitation. Eight patients also underwent a continuous wave Doppler examination. The diagnostic reliability of the pulsed Doppler technique was greater than or equal to 90%. The severity of the dysfunction was accurately assessed in 86% of cases. In the case of aortic regurgitation, mapping of the jets was performed as easily for prostheses as for native regurgitant valves. In the case of mitral regurgitation, the mapping patterns depended on the cause of the dysfunction. With valvar tears, a jet was detected at the centre of the annulus, and with paravalvar leaks eccentric atrial jets were seen opposite the site of the leak. The pulsed Doppler and the surgical findings correlated well for both the site of the dysfunction (16/20 (80%) patients) and the size of the leak (13/16 (81%) patients). Thus, despite some limitations, pulsed Doppler and particularly the mapping procedure provide sufficient information to give an accurate non-invasive assessment of prosthetic valve dysfunction.
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subjectAbridged Index Medicus ; Aortic Valve - physiopathology ; Aortic Valve Insufficiency - physiopathology ; Aortic Valve Stenosis - physiopathology ; Biological and medical sciences ; Cardiology. Vascular system ; cardiovascular system ; Echocardiography ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Heart Valve Diseases - physiopathology ; Heart Valve Prosthesis ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral Valve - physiopathology ; Prosthesis Design ; Research Article ; Ultrasonography - methods
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descriptionThirty patients with 33 mitral or aortic prostheses or both were examined using the pulsed Doppler technique combined with cross sectional echocardiography to study the applicability of the Doppler technique in the diagnosis and evaluation of the severity of prosthetic dysfunction and to assess the ability of the mapping procedure to estimate the site and the size of the prosthetic defect. The dysfunction was valvar regurgitation in 29 instances and stenoses in eight, all of which were confirmed by invasive procedures. The severity of the dysfunction was graded on a three point scale. A control group of 73 subjects with 88 normal prostheses also underwent pulsed Doppler and cross sectional echocardiography. The pulsed Doppler study followed the usual procedure for a valvar disease including two and three dimensional mapping for regurgitation. Eight patients also underwent a continuous wave Doppler examination. The diagnostic reliability of the pulsed Doppler technique was greater than or equal to 90%. The severity of the dysfunction was accurately assessed in 86% of cases. In the case of aortic regurgitation, mapping of the jets was performed as easily for prostheses as for native regurgitant valves. In the case of mitral regurgitation, the mapping patterns depended on the cause of the dysfunction. With valvar tears, a jet was detected at the centre of the annulus, and with paravalvar leaks eccentric atrial jets were seen opposite the site of the leak. The pulsed Doppler and the surgical findings correlated well for both the site of the dysfunction (16/20 (80%) patients) and the size of the leak (13/16 (81%) patients). Thus, despite some limitations, pulsed Doppler and particularly the mapping procedure provide sufficient information to give an accurate non-invasive assessment of prosthetic valve dysfunction.
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abstractThirty patients with 33 mitral or aortic prostheses or both were examined using the pulsed Doppler technique combined with cross sectional echocardiography to study the applicability of the Doppler technique in the diagnosis and evaluation of the severity of prosthetic dysfunction and to assess the ability of the mapping procedure to estimate the site and the size of the prosthetic defect. The dysfunction was valvar regurgitation in 29 instances and stenoses in eight, all of which were confirmed by invasive procedures. The severity of the dysfunction was graded on a three point scale. A control group of 73 subjects with 88 normal prostheses also underwent pulsed Doppler and cross sectional echocardiography. The pulsed Doppler study followed the usual procedure for a valvar disease including two and three dimensional mapping for regurgitation. Eight patients also underwent a continuous wave Doppler examination. The diagnostic reliability of the pulsed Doppler technique was greater than or equal to 90%. The severity of the dysfunction was accurately assessed in 86% of cases. In the case of aortic regurgitation, mapping of the jets was performed as easily for prostheses as for native regurgitant valves. In the case of mitral regurgitation, the mapping patterns depended on the cause of the dysfunction. With valvar tears, a jet was detected at the centre of the annulus, and with paravalvar leaks eccentric atrial jets were seen opposite the site of the leak. The pulsed Doppler and the surgical findings correlated well for both the site of the dysfunction (16/20 (80%) patients) and the size of the leak (13/16 (81%) patients). Thus, despite some limitations, pulsed Doppler and particularly the mapping procedure provide sufficient information to give an accurate non-invasive assessment of prosthetic valve dysfunction.
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