Original article
Normal values for Doppler echocardiographic assessment of heart valve prostheses

https://doi.org/10.1067/S0894-7317(03)00638-2Get rights and content

Abstract

Assessment of normal and abnormal function of heart valve prostheses remains challenging. Doppler echocardiography has been shown to allow hemodynamic evaluation in various clinical settings and has become the most widely used tool to assess prosthetic valve function. Prosthetic valves, even when they function normally, are to some degree obstructive to the blood flow. The normal values of gradients, pressure half-time, and effective orifice area depend on valve type and valve size. Doppler assessment of prosthetic valve function, thus, requires specification of valve type and valve size, and knowledge of the normal values. This study provides an updated overview on the available data of normal values to facilitate adequate interpretation of Doppler data.

Section snippets

Methods

A world literature search for normal Doppler echocardiographic values for prosthetic heart valves was performed using the MEDLINE database. All studies that reported Doppler measurements for normal prosthetic heart valves specifying valve type and size were included.

The so-obtained echocardiographic data were classified according to valve position, type, and size. For valves in the aortic position the following parameters were considered when available: peak gradient; mean gradient; peak

Results

A total of 88 articles providing information for normal values of valve prosthesis were included.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88 Data were available for 7092 valves in the aortic position

Discussion

This study provides a comprehensive, updated overview on normal values for Doppler gradients, pressure half-time, and effective orifice areas for prosthetic valves on the basis of currently available literature. The last such overview was published in the late 1980s and does not account for the different, new valve models that are currently used.89 These data should be very helpful for physicians treating patients who have undergone valve replacement. Because normal values differ markedly

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