- Review
- Open access
- Published:
The echocardiography of replacement heart valves
Echo Research & Practice volume 3, pages R35–R43 (2016)
Abstract
This is a practical description of how replacement valves are assessed using echocardiography. Normal transthoracic appearances including normal variants are described. The problem of differentiating normal function, patient–prosthesis mismatch and pathological obstruction in aortic replacement valves with high gradients is discussed. Obstruction and abnormal regurgitation is described for valves in the aortic, mitral and right-sided positions and when to use echocardiography in suspected infective endocarditis. The roles of transoesophageal and stress echocardiography are described and finally when other imaging techniques may be useful.
References
Lancellotti P, Pibarot P, Chambers J, Edvardsen T, Delgado V, Dulgheru R, Pepi M, Cosyns B, Dweck M, Garbi M, et al. 2016 Recommendations for the imaging assessment of prosthetic heart valves. A report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography. European Heart Journal: Cardiovascular Imaging. 17 589–590. ((doi:10.1093/ehjci/jew025)
Jamieson WR 2002 Current and advanced prostheses for cardiac valvular replacement and reconstruction surgery. Surgical Technology International 10 121–149.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O’Gara PT, Ruiz CE, Skubas NJ, Sorajja P, et al. 2014 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 129 e521–e643. ((doi:10.1161/CIR.0000000000000031)
Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, Borger MA, Carrel TP, De Bonis M, Evangelista A, et al. 2012 Guidelines on the management of valvular heart disease (version 2012). European Heart Journal 33 2451–2496. ((doi:10.1093/eurheartj/ehs109)
Grunkemeier GL, Li H-H, Naftel DC, Starr A, & Rahimtoola SH 2000 Long-term performance of heart valve prostheses. Current Problems in Cardiology 25 73–156. ((doi:10.1053/cd.2000.v25.a103682)
Rahimtoola SH 2010 Choice of prosthetic heart valve in adults. Journal of the American College of Cardiology 55 2413–2426. ((doi:10.1016/j.jacc.2009.10.085)
Flameng W, Herregods M-C, Vercalsteren M, Herijgers P, Bogaerts K, & Meuris B 2010 Prosthesis-patient mismatch predicts structural valve degeneration in bioprosthetic heart valves. Circulation 121 2123–2129. ((doi:10.1161/CIRCULATIONAHA.109.901272)
Akins CW, Miller DC, Turina MI, Kouchoukos NT, Blackstone EH, Grunkemeier GL, Takkenberg JJM, David TE, Butchart EG, Adams DH, et al. 2008 Guidelines for reporting mortality and morbidity after cardiac valve interventions. Journal of Thoracic and Cardiovascular Surgery 135 732–738. ((doi:10.1016/j.jtcvs.2007.12.002)
Blais C, Dumesnil JG, Baillot R, Simard S, Doyle D, & Pibarot P. 2003 Impact of valve prosthesis-patient mismatch on short-term mortality after aortic valve replacement. Circulation 108 983–938. ((doi:10.1161/01.CIR.0000085167.67105.32)
Vohra HA, Whistance RN, de Kerchove L, Glineur D, Noirhomme P, & El Khoury G 2013 Influence of higher valve gradient on long-term outcome after aortic valve repair. Annals of Cardiothoracic Surgery 2 30–39.
Chambers J, Myerson S, Rajani R, Morgan-Hughes G, Dweck M on behalf of the British Heart Valve Society. 2016 Multimodality imaging in heart valve disease. OpenHeart 3 e000330. ((doi:10.1136/openhrt-2015-0003312)
Baumgartner H, Khan S, DeRobertis M, Czer L, & Maurer G 1990 Discrepancies between Doppler and catheter gradients in aortic prosthetic valves in vitro. A manifestation of localized gradients and pressure recovery. Circulation 82 1467–1475. ((doi:10.1161/01.cir.82.4.1467)
Lancellotti P, Tribouilloy C, Hagendorff A, Moura L, Popescu BA, Agricola E, Monin J-L, Pierard LA, Badano L, & Zamorano JL 2010 European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). European Journal of Echocardiography 11 223–244. ((doi:10.1093/ejechocard/jeq030)
Zamorano JL, Badano LP, Bruce C, Chan K-L, Goncalves A, Hahn RT, Keane MG, La Canna G, Monaghan MJ, Nihoyannopoulos P, et al. 2011 EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. Journal of the American Society of Echocardiography 24 937–965 and European Heart Journal 32 2189–2214. ((doi:10.1016/j.echo.2011.07.003)
Lancellotti P, Moura L, Pierard LA, Agricola E, Popescu BA, Tribouilloy C, Hagendorff A, Monin, Badano L, Zamorano JL, et al. 2010 European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). European Journal of Echocardiography 11 307–332. ((doi:10.1093/ejechocard/jeq031)
Connolly HM, Miller FA, Taylor CL, Naessens JM, Seward JB, & Tajik AJ 1993 Doppler hemodynamic profiles of 82 clinically and echocardiographically normal tricuspid valve prostheses. Circulation 88 2722–2727. ((doi:10.1161/01.CIR.88.6.2722)
Kobayashi Y, Nagata S, Ohmori F, Eishi K, Nakano K, & Miyatake K 1996 Serial Doppler echocardiographic evaluation of bioprosthetic valves in the tricuspid position. Journal of the American College of Cardiology 27 1693–1697. ((doi:10.1016/0735-1097(96)00056-3)
Novaro GM, Connolly HM, & Miller FA 2001 Doppler hemodynamics of 51 clinically and echocardiographically normal pulmonary valve prostheses. Mayo Clinic Proceedings 76 155–160. ((doi:10.1016/S0025-6196(11)63122-4)
Thangaroopan M, & Choy JB 2005 Is transesophageal echocardiography overused in the diagnosis of infective endocarditis? American Journal of Cardiology 95 295–297. ((doi:10.1016/j.amjcard.2004.09.022)
Schulz R, Werner GS, Fuchs JB, Andreas S, Prange H, Ruschewski W, & Kreuzer H 1996 Clinical outcome and echocardiographic findings of native and prosthetic valve endocarditis in the 1990s. European Heart Journal 17 281–288. ((doi:10.1093/oxfordjournals.eurheartj.a014846)
Habib G, Badano L, Tribouilloy C, Vilacosta I, Zamorano JL, Galderisi M, Voigt J-U, Sicari R, Cosyns B, Fox K, et al. 2010 Recommendations for the practice of echocardiography in infective endocarditis. European Journal of Echocardiography 11 202–219. ((doi:10.1093/ejechocard/jeq004)
Garbi M, Chambers J, Vannan MA, & Lancellotti P 2015 Valve stress echocardiography: a practical guide for referral, procedure, reporting and clinical implementation of results. On behalf of the HAVEC group. JACC Imaging 8 724–736. ((doi:10.1016/j.jcmg.2015.02.010)
Das P, & Chambers J 2000 When is an aortic prosthesis too small? The need for dobutamine stress echocardiography. International Journal of Clinical Practice 54 261–262.
Teshima H, Hayashida N, Yano H, Nishimi M, Tayama E, Fukunaga S, Akashi H, Kawara T, & Aoyagi S 2003 Obstruction of St Jude Medical valves in the aortic position: histology and immunohistochemistry of pannus. Journal of Thoracic and Cardiovascular Surgery 126 401–407. ((doi:10.1016/S0022-5223(03)00702-5)
Funding
This article received no funding.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.
About this article
Cite this article
Chambers, J.B. The echocardiography of replacement heart valves. Echo Res Pract 3, R35–R43 (2016). https://doi.org/10.1530/ERP-16-0032
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1530/ERP-16-0032