Author + information
- Received August 4, 1986
- Revision received October 21, 1986
- Accepted November 17, 1986
- Published online May 1, 1987.
- ↵*Address for reprints: Patricia C. Come, MD, Department of Medicine, Cardiology Division, Beth Israel Hospital, 330 Brookline Avenue, Boston, Massachusetts 02115.
Pulsed Doppler echocardiographic diagnosis of periprosthetic valvular insufficiency may be difficult. This report details the pulsed Doppler echocardiographic findings in two patients who developed severe periprosthetic mitral regurgitation after porcine mitral valve replacement. In both patients, mitral regurgitation was difficult to diagnose and left atrial turbulence, when detected, appeared localized, suggesting only mild mitral regurgitation. However, the combination of abnormally high peak transmitral diastolic flow velocity, with a normal pressure half-time, and increased flow velocity in the tricuspid regurgitant jet compatible with severe pulmonary hypertension, in the absence of other apparent left heart disease, suggested the correct diagnosis of severe mitral regurgitation in both cases. Techniques for optimal pulsed Doppler assessment of the mitral anulus region are emphasized, as are the theoretic advantages of continuous wave and color-coded pulsed Doppler echocardiography for detection of periprosthetic regurgitation.
- Received August 4, 1986.
- Revision received October 21, 1986.
- Accepted November 17, 1986.
- American College of Cardiology Foundation