Pathologic and angiographic correlations of transesophageal echocardiography in prosthetic heart valve dysfunction

Farooq A. Chaudhry, Cesar Herrera, Paul F. DeFrino, David J. Mehlman, Miguel Zabalgoitia*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

To determine the diagnostic accuracy of transesophageal echocardiography (TEE) in prosthetic valve dysfunction, the pathologic and/or angiographic data from 37 valves were compared with that obtained by transesophageal and transthoracic echocardiography. Of the 21 prostheses with severe regurgitation, TEE identified all 14 mitral, the five aortic, and one of the two tricuspid valves; on the other hand transthoracic echocardiography identified 2 of the 14 mitral, the five aortic, and one of the two tricuspid valves. Of the 10 prostheses with flail cusp(s), nine (90%) were correctly identified by TEE and four (40%) were correctly identified by transthoracic echocardiography. All five prostheses with paravalvular regurgitation were detected through the esophageal window and one detected through the precordial window. TEE was unable to document the two prosthetic aortic stenoses, whereas the transthoracic examination correctly quantified the gradient in one but underestimated it in the other case. Seven patients underwent valve replacement on the basis of the clinical and TEE information alone. In assessing cause, origin, and severity of prosthetic mitral regurgitation, TEE is the method of choice. In selected cases, TEE can avoid angiography and facilitate optimal timing of reoperation. In suspected aortic and tricuspid dysfunction, TEE may provide additional morphologic, but limited hemodynamic information.

Original languageEnglish (US)
Pages (from-to)1057-1064
Number of pages8
JournalAmerican heart journal
Volume122
Issue number4 PART 1
DOIs
StatePublished - Oct 1991

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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