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The ESC Textbook of Cardiovascular Imaging pp 177–203Cite as

Heart Valve Prostheses

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Abstract

Prosthetic heart valves may be mechanical or bioprosthetic. Mechanical valves, which are composed primarily of metal or carbon alloys, are classified according to their design as ball-caged, single-tilting-disc, or bileaflet-tilting-disc valves (Fig. 9.1). In ball-caged valves, the occluder is a sphere that is contained by a metal “cage” when the valve is in its open position, and fills the orifice when the valve is in its closed position. In single-tilting-disc valves, the occluder is a single circular disc that is constrained in its motion by a cage, a central strut, or a slanted slot in the valve ring; therefore, it opens at an angle less than 90° to the sewing ring plane. In bileaflet-tilting-disc valves, the two occluders are two semicircular discs that open forming three orifices–a central one and two lateral ones.

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References

  1. Yoganathan AP, He Z, Casey J. Fluid mechanics of heart valves. Annu Rev Biomed Eng. 2004;6:331–362

    Article  CAS  PubMed  Google Scholar 

  2. Gillinov AM, Blackstone EH, Rodriguez LL. Prosthesis-patient size: measurement and clinical implications. J Thorac Cardiovasc Surg. 2003;126:313–316

    Article  PubMed  Google Scholar 

  3. Flaschkampf FA, Weyman AE, Guerrero JL. Influence of orifice geometry and flow rate on effective valve area: an in vitro study. J Am Coll Cardiol. 1991;15:1173–1180

    Article  Google Scholar 

  4. Van den Brink RBA. Evaluation of prosthetic heart valves by transesophageal echocardiography: problems, pitfalls, and timing of echocardiography. Semin Cardiothorac Vasc Anesth. 2006;10:89–100

    Article  PubMed  Google Scholar 

  5. Baumgartner H, Khan S, DeRobertis M, et al Discrepancies between Doppler and catheter gradients in aortic prosthetic valves in vitro: a manifestation of localized pressure gradients and pressure recovery. Circulation. 1990;82:1467–1475

    CAS  PubMed  Google Scholar 

  6. Rothbart RM, Smucker ML, Gibson RS. Overestimation by Doppler echocardiography of pressure gradients across Starr–Edwards prosthetic valves in the aortic position. Am J Cardiol. 1988;61: 475–476

    Article  CAS  PubMed  Google Scholar 

  7. Badano LP, Mocchegiani R, Bertoli D, et al Normal echocardiographic characteristics of the Sorin–Bicarbon bileaflet prosthetic heart valve in mitral and aortic position. J Am Soc Echocardiogr. 1997;10:632–643

    Article  CAS  PubMed  Google Scholar 

  8. Currie PJ, Seward JB, Reeder GS, et al Continuous wave Doppler echocardiographic assessment of severity of calcific aortic stenosis: a simultaneous Doppler–catheter correlative study in 100 adult patients. Circulation. 1985;71:1162–1169

    CAS  PubMed  Google Scholar 

  9. Badano LP, Zamorano JL, Pavoni D, et al Clinical and hemodynamic implications of supra-annular implant of biological aortic valves. J Cardiovasc Med. 2006;7:524–532

    Article  Google Scholar 

  10. McDonald ML, Daly RC, Schaff HV, et al Hemodynamic performance of small aortic valve bioprostheses: is there a difference? Ann Thorac Surg. 1997;63:362–366

    Article  CAS  PubMed  Google Scholar 

  11. Chafizadeh ER, Zoghbi WA. Doppler echocardiographic assessment of the St Jude Medical prosthetic valve in the aortic position using the continuity equation. Circulation. 1991;83:213–223

    CAS  PubMed  Google Scholar 

  12. Walther T, Falk V, Autschbach R, et al Hemodynamic assessment of the stentless Toronto SPV bioprosthesis by echocardiography. J Heart Valve Dis. 1994;3:657–665

    CAS  PubMed  Google Scholar 

  13. Caldwell RL, Girod DA, Hurwitz RA, Mahoney L, King H, Brown J. Pre-operative two-dimensional echocardiographic ­prediction of prosthetic aortic and mitral valve size in children. Am Heart J. 1987;113:873–878

    Article  CAS  PubMed  Google Scholar 

  14. Harpaz D, Shah P, Bezante G, Heo M, Stewart S, Hicks GL. Transthoracic and transesophageal echocardiographic sizing of the aortic annulus to determine prosthesis size. Am J Cardiol. 1993;72: 1411–1417

    Article  CAS  PubMed  Google Scholar 

  15. Yoganathan AP, Cape EG, Sung H, Williams FP, Timoh A. Review of hydrodynamic principles for the cardiologist: application to the study of blood flow and jets by imaging techniques. J Am Coll Cardiol. 1988;12:1344–1353

    Article  CAS  PubMed  Google Scholar 

  16. Badano LP, Bertoli D, Astengo D, et al Doppler hemodynamic assessment of clinically and echocardiographically normal mitral and aortic Allcarbon valve prostheses: Valve Prosthesis Ligurian Cooperative Doppler study. Eur Heart J. 1993;14:1602–1609

    CAS  PubMed  Google Scholar 

  17. Rosenheck R, Binder T, Maurer G. Normal values for Doppler echocardiographic assessment of heart valve prostheses. J Am Soc Echocardiogr. 2003;16:1116–1127

    Article  Google Scholar 

  18. David TE, Armstrong S, Sun Z. Clinical and hemodynamic assessment of the Hancock II bioprosthesis. Ann Thorac Surg. 1992;54: 661–667

    Article  CAS  PubMed  Google Scholar 

  19. Badano LP, Pavoni D, Musumeci S, et al Stented bioprosthetic valve hemodynamics. How much is the supra-annular implant better than the intra-annular one? J Heart Valve Dis. 2006;15:238–246

    PubMed  Google Scholar 

  20. Pibarot P, Dumesnil JG, Jobin J, Cartier P, Honos G, Durand LG. Hemodynamic and physical performance during maximal exercise in patients with an aortic bioprosthetic valve: comparison of stentless versus stented bioprostheses. J Am Coll Cardiol. 1999;34: 1609–1617

    Article  CAS  PubMed  Google Scholar 

  21. Seiler C. Management and follow-up of prosthetic heart valves. Heart. 2004;90:818–824

    Article  PubMed  Google Scholar 

  22. Bonow RO, Carabello BA, Chatterje K, et al Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. J Am Coll Cardiol. 2008;52: e1–142

    Article  PubMed  Google Scholar 

  23. Vahanian A, Baumgartner H, Bax J, et al Task force on the management of valvular heart disease of the european society of cardiology; esc committee for practice guidelines. Guidelines on the management of valvular heart disease. Eur Heart J. 2007;28:230–268

    PubMed  Google Scholar 

  24. Pellikka PA, Nagueh SF, Elhendy AA, Kuehl CA, Sawada SG. American Society of Echocardiography recommendations for performance, interpretation, and application of stress echocardiography. J Am Soc Echocardiogr. 2007;20:1021–1041

    Article  PubMed  Google Scholar 

  25. Sicari R, Nihoyannopoulos P, Evangelista A, et al Stress echocardiography expert consensus statement from the European Association of Echocardiography. Eur J Echocardiogr. 2008;9:415–437

    Article  PubMed  Google Scholar 

  26. Decena BF III, Tischler MD. Stress echocardiography in valvular heart disease. Cardiol Clin. 1999;17:555–572

    Article  PubMed  Google Scholar 

  27. Bacassis P, Hayot M, Frapier JM, et al Postoperative exercise tolerance after aortic valve replacement by small-size prosthesis. J Am Coll Cardiol. 2000;36:871–877

    Article  Google Scholar 

  28. Pibarot P, Dumesnil JG. Prosthesis–patient mismatch: definition, clinical impact, and prevention. Heart. 2006;92:1022–1029

    Article  CAS  PubMed  Google Scholar 

  29. Medalion B, Blackstone E, Lytle B, White J, Arnold J, Cosgrove D. Aortic valve replacement: is valve size important? J Thorac Cardiovasc Surg. 2000;119:963–974

    Article  CAS  PubMed  Google Scholar 

  30. Rahimtoola SH. Is severe valve prosthesis–patient mismatch ­(VP–PM) associated with a higher mortality? Eur J Cardiothorac Surg. 2006;30:1

    Article  PubMed  Google Scholar 

  31. Rahimtoola SH. The problem of valve prosthesis–patient mismatch. Circulation. 1978;58:20–24

    CAS  PubMed  Google Scholar 

  32. Muratori M, Montorsi P, Teruzzi G, et al Feasibility and diagnostic accuracy of quantitative assessment of mechanical prostheses leaflet motion by transthoracic and transesophageal echocardiography in suspected prosthetic valve dysfunction. Am J Cardiol. 2006;97: 94–100

    Article  PubMed  Google Scholar 

  33. Pennel DJ, Sechtem UP, Higgins CB, et al Society for Cardiovascular Magnetic Resonance; Working Group on Cardiovascular Magnetic Resonance of the European Society of Cardiology. Clinical indications for cardiovascular magnetic resonance (CMR): consensus panel report. Eur Heart J. 2004;25:1940–1965

    Article  Google Scholar 

  34. Caceres-Loriga FM, Perez-Lopez H, Santos-Garcia J, Morlans-Hernandez K. Prosthetic heart valve thrombosis: pathogenesis, diagnosis and management. Int J Cardiol. 2006;110:1–6

    Article  PubMed  Google Scholar 

  35. Bottio T, Casarotto D, Thiene G, Caprili L, Angelini A, Gerosa G. Leaflet escape in a new bileaflet mechanical valve: TRI technologies. Circulation. 2003;107:2303–2306

    Article  PubMed  Google Scholar 

  36. Pavoni D, Badano LP, Ius F, et al Limited long-term durability of the Cryolife O’Brien stentless porcine xenograft valve. Circulation. 2007;116:I307–I313

    Article  PubMed  Google Scholar 

  37. Sagar KB, Wann LS, Paulsen WH, Romhilt DW. Doppler echocardiographic evaluation of Hancock and Bjork-Shiley prosthetic values. J Am Coll Cardiol 1986;7:681–687

    Article  CAS  PubMed  Google Scholar 

  38. Wilkins GT, Gillam LD, Kritzer GL, Levine RA, Palacios IF, Weyman AE. Validation of continuous-wave Doppler echocardiographic measurements of mitral and tricuspid prosthetic valve gradients: a simultaneous Doppler- catheter study. Circulation 1986; 74:786–795

    CAS  PubMed  Google Scholar 

  39. Burstow DJ, Nishimura RA, Bailey KR, Reeder GS, Holmes DR Jr, Seward JB, Tajik AJ. Continuous wave Doppler echocardiographic measurement of prosthetic valve gradients. A simultaneous Doppler-catheter correlative study. Circulation 1989;80:504–514

    Google Scholar 

  40. Baumgartner H, Khan S, DeRobertis M, Czer L, Maurer G. Discrepancies between Doppler and catheter gradients in aortic prosthetic valves in vitro. A manifestation of localized gradients and pressure recovery. Circulation 1990;82:1467–1475

    Google Scholar 

  41. Stewart SF, Nast EP, Arabia FA, Talbot TL, Proschan M, Clark RE. Errors in pressure gradient measurement by continuous wave Doppler ultrasound: type, size and age effects in bioprosthetic aortic valves. J Am Coll Cardiol 1991;18:769–779

    Google Scholar 

  42. Baumgartner H, Khan S, DeRobertis M, Czer L, Maurer G. Effect of prosthetic aortic valve design on the Doppler-catheter gradient correlation: an in vitro study of normal St. Jude, Medtronic-Hall, Starr-Edwards and Hancock valves. J Am Coll Cardiol 1992;19: 324–332

    Google Scholar 

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Authors and Affiliations

  1. Laboratorio di Ecocardioglafia, Departimento Scienze Cardiopolmonari, Azienda Ospedaliero-Universitaria “S Maria della Misericordia”, P. le S. Maria della Misericordia 15, 33100, Udine, Italy

    Luigi P. Badano

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  1. Luigi P. Badano
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  2. Rosa Sicari
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Corresponding author

Correspondence to Luigi P. Badano .

Editor information

Editors and Affiliations

  1. Hospital Clinico San Carlos, Instituto Cardiovascular, C/Professor Martin Lagos, s/n, 28040, Madrid, Spain

    José Luis Zamorano

  2. Medical Center Dept. Cardiology, Leiden University, Albinusdreef 2, 2333, Leiden, ZA, Netherlands

    Jeroen J. Bax

  3. Dept. Cardiology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Frank E. Rademakers

  4. Turku PET Centre, Turku University Hospital, FI-20521, Turku, Finland

    Juhani Knuuti

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Badano, L.P., Sicari, R. (2010). Heart Valve Prostheses. In: Zamorano, J.L., Bax, J.J., Rademakers, F.E., Knuuti, J. (eds) The ESC Textbook of Cardiovascular Imaging. Springer, London. https://doi.org/10.1007/978-1-84882-421-8_9

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  • DOI: https://doi.org/10.1007/978-1-84882-421-8_9

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-420-1

  • Online ISBN: 978-1-84882-421-8

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