The echocardiographic evaluation of valve prostheses

Transthoracic and transesophageal echocardiography were used to demonstrate prosthetic valve dysfunction in 134 patients with cardiac prosthetic valves in aortic, mitral and tricuspid position. Transthoracic echocardiography showed a high accuracy in the diagnosis of prosthetic valve dysfunction, especially in aortic position or when a stenosis was present. Transesophageal echocardiography allowed to verify the etiology and site of dysfunction and to show even minor leaks. Sixty-six patients underwent reoperation while 68 underwent a clinical and echocardiographic follow-up because only mild symptoms were present. Thus echocardiography represents the technique of choice in the follow-up of patients with prosthetic valves and it is able to help in decision making. However, cardiac catheterization is mandatory if a disagreement between clinical and echocardiographic data is present or when coronary artery disease is suspected or present.