Echocardiographic studies after mitral valve replacement

Abstract

Echocardiography may be used to study patients after mitral valve surgery in two separate ways. The first of these, direct observation of the prosthesis¹ or homograft², has been valuable in determining its normal appearance and, in the case of mechanical prostheses, in detecting abnormalities of movement caused by degeneration or thrombosis. However, it is an approach with limitations, since records of this type may be totally normal in spite of severe malfunction. We have therefore found it more informative to direct our attention not primarily at the prosthesis, but at the effects of the prosthesis or homograft on the pattern of left ventricular wall movement during filling. Although direct inspection of the echocardiogram may give useful information, particularly in the presence of mitral paraprosthetic regurgitation³, the value of the method can be considerably increased if a simple computing technique is used, and transverse left ventricular dimension, measured as the distance between the septum and posterior wall endocardium, is displayed continuously throughout the cardiac cycle.