Journal article
Single-plane transesophageal echocardiography for assessing function of mechanical or bioprosthetic valves in the aortic valve position
The American journal of cardiology, v 69(16), pp 1310-1315
1992
PMID: 1585865
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Abstract
To assess the value and limitations of single-plane transesophageal echocardiography in the evaluation of prosthetic aortic valve function, 89 patients (69 mechanical and 20 bioprosthetic aortic valves) were studied by combined transthoracic and transesophageal 2-dimensional and color flow Doppler echocardiography. In the assessment of aortic regurgitation, the transthoracic and transe sophageal echocardiographic findings were concordant in 71 of 89 patients (80%). In 8 patients, the degree of aortic regurgitation was underestimated by the transthoracic approach; in each case the quality of the transthoracic echocardiogram was poor. In 10 patients, transesophageal echocardiography failed to detect trivial aortic regurgitation due to acoustic shadowing of the left ventricular outflow tract from a mechanical valve in the mitral valve position. Transesophageal echocardiography was superior to transthoracic echocardiography in diagnosing perivalvular abscess, subaortic perforation, valvular dehiscence, torn or thickened bioprosthetic aortic valve cusps, and in clearly distinguishing perivalvular from valvular aortic regurgitation. Transesophageal echocardiography correctly diagnosed bioprosthetic valve obstruction in 1 patient, but failed to diagnose mechanical valve obstruction in another.
In conclusion, transesophageal echocardiography offers no advantage over the transthoracic approach in the detection and quantification of prosthetic aortic regurgitation unless the transthoracic image quality is poor. Transesophageal echocardiography is limited in detecting mechanical valve obstruction and in detecting aortic regurgitation in the presence of a mechanical prosthesis in the mitral valve position. However, it is superior to transthoracic echocardiography in identifying perivalvular pathology, differentiating perivalvular from valvular regurgitation and in defining the anatomic abnormality responsible for the prosthetic valve dysfunction. Combined transthoracic and transesophageal examination provides complete anatomic and hemodynamic assessment of prosthetic aortic valve function.
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Details
- Title
- Single-plane transesophageal echocardiography for assessing function of mechanical or bioprosthetic valves in the aortic valve position
- Creators
- Dean G. Karalis - Cardiovascular Institute of the SouthKrishnaswamy Chandrasekaran - Cardiovascular Institute of the SouthJohn J. Ross - Cardiovascular Institute of the SouthAlan Micklin - Cardiovascular Institute of the SouthBruce M. Brown - Cardiovascular Institute of the SouthJian-Fang Ren - Cardiovascular Institute of the SouthGary S. Mintz - Cardiovascular Institute of the South
- Publication Details
- The American journal of cardiology, v 69(16), pp 1310-1315
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:A1992HU93900013
- Scopus ID
- 2-s2.0-0026695648
- Other Identifier
- 991019348759804721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems