Prosthetic Valves

Front 1

Name the two types of Prosthetic Valves.

Back 1

Mechanical Valves are made of stainless steel or Dacron Graft.

Bioprosthetic Valves are harvested from pigs or cows which last from 10-12 years.

Front 2

Define a mechanical valve.

Back 2

They are a synthetic metallic valve.
The Doppler velocity should be less 3 millimeters per second.
The patient will hear a clicking sound.
During an Echo they are distinguish by their acoustic shadow.
Patient must take a blood thinner like Coumadin, Warfarin
Mechanical Prosthetic valve will outlast most patients.

Front 3

There are three types of mechanical valves.

Back 3

#1.)Ball and Cage Valves (Starr Edwards Valve).

#2.)Tilting Disc (Bjork - Shiley).

#3.)Bi-leaflet (St. Jude) Least stenoic

Front 4

Define a Bio-prosthetic Valve replacement.

Back 4

Either from a (Pig) Porcine Carpenter Edwards
or (Cow) Bovine Ionescu - Shiley.

A.)Semilunar are replaced by Porcine
B.)Atrioventricular are replaced by Bovine

Valves usually last 10 - 12 years.

Homo graft valves - taken from another human being
Autograft valves - made from your own tissue

Front 5

Etiology of prosthetic valves.

Back 5

Native valves are replaced for reasons like stenosis, regurgitation, and infection.

Valve repairs are becoming more common with porcine valves and bovine valves especially Mitral valves.

Front 6

Pathophysiology of the prosthetic valves.

Back 6

Complications include systemic embolization, perivalvular leaks, valve degeneration, thrombus formation, and endocarditis.

All prosthetic have a transvalvular gradient.

Front 7

Physical Signs of prosthetic valves.

Back 7

Mechanical valves have a systolic click.

Bioprosthetic valves do no click.

Front 8

Echo Findings of prosthetic valves.

Back 8

They are specific to each valve.

Valve motion is best studied by M mode to record to maximum disc motion.

TEE is very helpful for the evaluation of vegetations and or thrombus.

Front 9

Doppler for prosthetic valves.

Back 9

Normal mechanical prosthetic valve will have some regurgitation.

Valve should be checked for prosthetic leaks due to poor measurement.

TEE is necessary for evaluating MR.

Front 10

How do we evaluate prosthetic valves?

Back 10

Zoom in Doppler trace the entire wave form.
On AV valves trace the top.
On Semilunar valves trace the bottom.

Use CW (continuous flow)

Mitral Prosthetic - 1.5 - 2.0 meters per second peak velocity
mean gradient 3-7mmHg

Aortic Prosthetic - 2.0 - 3.0 meters per second peak velocity
mean gradient 14-20 mmHG