Prosthetic reverberations
by Sepehr Richard W

Interesting Cases in Echocardiography

by Navin C Nanda
About Video

Two leaflets of the prosthetic valve are well seen next to each other in diastole but in systole they go out of view making it difficult to assess whether they opened fully and briskly. Viewing the prosthetic valve from different planes and angulations or using 3D TTE may help detect its motion in systole. Full and brisk (90 degree) opening indicates absence of any obstruction caused by pannus or a thrombus. Variable pressure gradients are noted with practically all types of aortic prosthetic valves specially mechanical ones but high gradients in the presence of normally moving leaflets would suggest obstruction elsewhere such as in the LVO/subaortic/supravalvar region, severe AR or prosthetic patient mismatch particularly when a small prosthesis is implanted.

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