Author + information
- Received August 22, 1988
- Revision received November 21, 1988
- Accepted December 16, 1988
- Published online June 1, 1989.
- Kanwal K. Kapur, MD,
- Pohoey Fan, MD,
- Navin C. Nanda, MD, FACC∗,
- Ajit P. Yoganathan, PhD and
- Rajendra G. Goyal, MD
- ↵∗Address for reprints: Navin C. Nanda, MD, University of Alabama, Heart Station, SWB/W001, Birmingham, Alabama 35294.
Doppler color flow mapping and color-guided conventional Doppler studies were performed on 119 patients with 126 prosthetic valves (mitral alone in 60, aortic alone in 52 and both mitral and aortic in 7 patients) within 2 weeks of the catheterization study or surgery, or both. The mean pressure gradients derived by color-guided continuous wave Doppler ultrasound correlated well with those obtained at catheterization for both the tissue and mechanical mitral and aortic prostheses (r = 0.85 to 0.87). For the effective prosthetic orifice areas, better correlation with catheterization results were obtained with the tissue mitral (r = 0.94) and tissue aortic (r = 0.87) prostheses than with the mechanical mitral (r = 0.79) and mechanical aortic (r = 0.76) prostheses. The maximal width of the color flow signals at their origin from the tissue mitral prostheses also correlated well with the effective prosthetic orifice area at catheterization (r = 0.81).
Doppler color flow mapping identified prosthetic valvular regurgitation with a sensitive and specificity of 89% and 100%, respectively, for the mitral and 92% and 83% for the aortic prostheses. There was complete agreement between the Doppler color flow mapping and angiographic grading of the severity of prosthetic valvular regurgitation in 90% of mitral and 73.5% of the aortic regurgitant prostheses with under- or overestimation by > 1 grade in only two cases. Valvular and paravalvular regurgitation was correctly categorized by Doppler color flow mapping in relation to the surgical findings in 94% of the mitral and 80.5% of the aortic prostheses.
- Received August 22, 1988.
- Revision received November 21, 1988.
- Accepted December 16, 1988.