Echocardiographic evaluation of prosthetic heart valves

Jude Medical Trifecta aortic valve: results from a prospective regional multicentre registry
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Jude Medical mitral valve prosthesis.

This device includes valves constructed of prosthetic materials, biologic valves (e.g., porcine valves), or valves constructed of a combination of prosthetic and biologic materials.

T1 - Patterns of normal transvalvular regurgitation in mechanical valve prostheses
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Medical management of prosthetic aortic valve …

N2 - The magnitude and spatial distribution of normal leakage through mechanical prosthetic valves were studied in an in vitro model of mitral regurgitation. The effective regurgitant orifice was calculated from regurgitant rate at different transvalvular pressure differences and flow velocities. This effective orifice area was 0.6 to 2 mm2 for three tilting disc prostheses (Medtronic-Hall sizes 21, 25 and 29) and 0.2 to 1.1 mm2 for three bileaflet valves (St. Jude Medical sizes 21, 25 and 33). In the single disc valves, Doppler color flow examination disclosed a prominent central regurgitant jet around the central hole for the strut, accompanied by minor leakage along the rim of the disc (central to peripheral jet area ratio 3.3 ± 1.2). The bileaflet prostheses showed a peculiar complex pattern: in planes parallel to the two disc axes, convergent peripherally arising jets were visualized, whereas in orthogonal planes several diverging jets were seen. Mounting the disc and bileaflet valves on a water-filled tube allowed reproduction and interpretation of this pattern: for the bileaflet valve, the jets originated predominantly from valve ring protrusions that contained the axis hinge points and created a converging V pattern in planes parallel to the leaflets and a diverging V pattern in orthogonal planes. Similar patterns were observed during transesophageal echocardiography in 20 patients with a normally functioning St. Jude prosthesis. In 10 patients with a Medtronic-Hall valve, a dominant central jet was observed with one or more smaller peripheral jets. The median central to peripheral jet area ratio was 5 to 1. In summary, in two types of mechanical valve prostheses, effective leakage orifice areas are reported and criteria proposed for the differentiation of "physiologic" and pathologic regurgitation based on the spatial configuration of the jets.

Jude Medical valve in the right (pulmonary) side and in 3 (12%) of 26 with the valve in the left (systemic) side of the circulation.
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For multiple reasons, two different mechanical valve prostheses are inserted in the mitral position at the Montreal Heart Institute and selection is left to the surgeon’s discretion. In the present study, the two valve types were included because the purpose of the study was to examine the population of patients with mechanical valve replacement. Some differences between the two valve types were observed; however, caution must be exerted because the valve specifications were those given by different groups of investigators (–) and the comparison of the two valve types was beyond the scope of the present study. We designed the study retrospectively to maximize the number of patients in the study as well as to have a long follow-up time, allowing observation of the effect of mitral PPM on long-term follow-up. Unfortunately, this design did not allow the use of EOA values coming from the individual patients of our cohort.

T1 - Five year follow-up after valve replacement with the St. Jude Medical valve in infants and children
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Prosthetic valves Flashcards | Quizlet

Jude Medical Trifecta aortic valve: results from a prospective regional multicentre registry..pdf

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When Starr-Edwards prosthetic valves are located in both the ..

METHODS: Between January 2011 and June 2012, 178 consecutive patients undergoing aortic valve replacement with the Trifecta bioprosthesis were prospectively enrolled at 9 Italian centers.

Jude aortic prosthetic heart ..

Patient-prosthesis mismatch (PPM) in the aortic position has been studied for a decade and is a widely accepted concept, although its exact influence on long-term outcome remains controversial (). Despite the fact that the cardiac output is the same through the aortic and the mitral valve, the adequacy between a patient’s surface area and the valve’s area has been less studied in the mitral position. The consequence of Poiseuille’s law related to the given cardiac output that flows through a restrictive mitral valve is more obscure in the mitral position. Thus, the clinical impacts might be more difficult to identify and the threshold ratio between the effective orifice area (EOA) of the valve and the body surface area (BSA) defined as the indexed EOA (EOAi) remains to be defined. A strong correlation was identified between the persistence of residual pulmonary hypertension after mitral valve replacement and an EOAi of lower than 1.2 cm2/m2 (). The same threshold was associated with recurrent heart failure and worse long-term survival (,). Some studies on this subject have included bioprosthetic valves that are subject to deterioration, especially in the mitral position, with a theoretical orifice area that could be overestimated compared with the actual one, especially a few years after implantation. The main objective of the present study was to evaluate the incidence of mitral PPM in a large population of patients with mechanical mitral valve replacement and its effect on long-term outcome.