Transesophageal echocardiography in the evaluation of prosthetic and native aortic valves

Dittrich, Howard C.; McCann, Hugh A.; Walsh, Timothy P.; Blanchard, D. G.; Oppenheim, Gary; Waack, Timothy C.; Donaghey, Linda B.; Wheeler, Karen

doi:10.1016/0002-9149(90)91145-v

Cited by 25 publications

(4 citation statements)

References 10 publications

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“…Transe sophageal echocardiography more precisely defined the location and nature of the shunt, clearly demonstrated an associated secondary perivalvular leak independent of the left to right shunt and showed remnants of a healed vege tation. Thus, for unusual complications of valve surgery, the combined use of transthoracic and transesophageal echocardiography may give complementary information [15]. The findings of this study and two other recent reports [5,16] suggest that transesophageal imaging is indicated for the evaluation of suspected left to right shunts after prosthetic valve surgery, even several years after surgery.…”

Section: Echocardiographie Findingssupporting

confidence: 51%

Diagnosis of Left Ventricular Outflow Tract-Right Atrial Shunt Using Color Flow Doppler and Transesophageal Echocardiography

Mathis¹,

Rahko²

1992

Am J Noninvas Cardiol

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Section: Echocardiographie Findingssupporting

confidence: 51%

Diagnosis of Left Ventricular Outflow Tract-Right Atrial Shunt Using Color Flow Doppler and Transesophageal Echocardiography

Mathis¹,

Rahko²

1992

Am J Noninvas Cardiol

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“…23 TEE is the only validated alternative if TTE remains nondiagnostic. 4,24 How- ever, many patients perceive TEE to be unpleasant because of its semi-invasive nature, and TEE planimetry of the orifice area can be complicated by difficulties in obtaining the correct crosssectional view of the prosthetic cusps. 25 In the future, 3-dimensional imaging techniques may improve the ability to quantify prosthetic valve area by echocardiography, 26,27 but these techniques have not yet entered routine clinical practice.…”

Section: Echocardiographic Assessment Of the Prosthetic Orifice Area mentioning

confidence: 99%

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Knobelsdorff‐Brenkenhoff

Rudolph

Waßmuth

et al. 2009

Circ: Cardiovascular Imaging

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Background-Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses. Methods and Results-CMR planimetry of the orifice area was performed in 65 patients (43/22 stented/stentless prostheses; mean time since implantation, 3.1Ϯ2.8 years; mean orifice area [TTE], 1.70Ϯ0.43 cm 2 ; 62 normally functioning prostheses, 2 severe stenoses, and 1 severe regurgitation) in an imaging plane perpendicular to the transprosthetic flow using steady-state free-precession cine imaging under breath-hold conditions on a 1.5-T MR system. CMR results were compared with TTE (continuity equation, nϭ65) and TEE (planimetry, nϭ31). CMR planimetry was readily feasible in 80.0%; feasible with limitation in 15.4% because of stent, flow, and sternal wire artifacts; and impossible in 4.6% because of flow artifacts. Correlations of the orifice areas by CMR with TTE (rϭ0.82) and CMR with TEE (rϭ0.92) were significant. The average difference between the methods was Ϫ0.02Ϯ0.24 cm 2 (TTE) and 0.05Ϯ0.15 cm 2 (TEE). Agreement was present for stented and stentless devices and independent of orifice size. Intraobserver and interobserver variabilities of CMR planimetry were 6.7Ϯ5.4% and 11.5Ϯ7.8%. Conclusions-The assessment of aortic bioprostheses with normal orifice areas by CMR is technically feasible and provides orifice areas with a close correlation to echocardiography and low observer dependency. (Circ Cardiovasc Imaging. 2009;2:397-404.)

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“…Nowadays we apply not only transthoracic but also transesophageal echocardiography in cases of acute endocarditis or suspected prosthetic valve dysfunction, and these methods were also in some cases used to describe the findings among our patients who underwent reoperation. Transesophageal echocardiography can be used for an evaluation of the aortic valve, 24 but its greatest potential and value is in the evaluation of malfunctioning mitral valves, particularly for paravalvular regurgitation. 25,26 It is highly recommended that transesophageal echocardiography be performed in cases of suspected prosthetic valve malfunction and negative transthoracic investigation.…”

Section: Discussionmentioning

confidence: 99%

Long-term doppler echocardiographic results of aortic or mitral valve replacement with biocor porcine bioprosthesis

Mykén

Berggren

Larsson

et al. 1998

The Journal of Thoracic and Cardiovascular Surgery

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Transesophageal echocardiography in the evaluation of prosthetic and native aortic valves

Cited by 25 publications

References 10 publications

Diagnosis of Left Ventricular Outflow Tract-Right Atrial Shunt Using Color Flow Doppler and Transesophageal Echocardiography

Diagnosis of Left Ventricular Outflow Tract-Right Atrial Shunt Using Color Flow Doppler and Transesophageal Echocardiography

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Long-term doppler echocardiographic results of aortic or mitral valve replacement with biocor porcine bioprosthesis

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