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The Journal of Cardiovascular Surgery 2001 June;42(3):303-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Doppler echocardiographic evaluation of St. Jude Medical valves in the tricuspid position. Criteria for normal and abnormal valve function

Sezai A., Shiono M., Akiyama K., Orime Y., Hata H., Yagi S., Tsukamoto S., Nakata K., Hata M., Negishi N., Sezai Y.

From the Second Department of Surgery Nihon University School of Medicine, Tokyo, Japan


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Background. Although ­this exam­ina­tion ­for ­mitral ­and aor­tic pros­thet­ic ­valves ­has ­been fre­quent­ly report­ed to be avail­able ­for ­the ear­ly diag­no­sis of com­pli­ca­tions, ­there ­are ­few ­reports on exam­ina­tions ­for tri­cus­pid pros­thet­ic ­valves, par­tic­u­lar­ly ­the mechan­i­cal ­valve ­such as ­the St. Jude Medical (­SJM) ­valve. Furthermore, ­the cri­te­ria ­for ear­ly diag­no­sis of com­pli­ca­tions ­are unknown. The pur­pose of ­this ­study is to eval­u­ate ­the ­SJM ­valve in ­the tri­cus­pid posi­tion by Doppler ech­o­car­di­og­ra­phy ­and to ana­lyze ­valve-relat­ed com­pli­ca­tions.
Methods. Between September 1978 ­and March 1997, 46 ­patients under­went tri­cus­pid ­valve replace­ments ­with ­SJM ­valves; ­these cas­es ­were eval­u­at­ed by Doppler ech­o­car­di­og­ra­phy. We divid­ed ­the cas­es ­into Normal ­and Complication ­groups.
Results. In ­the Normal ­group, ­peak pres­sure gra­di­ent ­was 4.2±1.5 mmHg ­and pres­sure ­half-­time ­was 123.5±22.9 ­msec. In ­the Complication ­group, ­peak pres­sure gra­di­ent ­was 12.7±3.6 mmHg ­and pres­sure ­half-­time ­was 271.8±76.4 ­msec. In ­the Complication ­group, ­the low­est ­peak pres­sure gra­di­ent ­case ­was 8.0 mmHg ­and ­the short­est pres­sure ­half-­time ­was 160.0 ­msec.
Conclusions. We con­clud­ed ­that ­when ­the ­peak pres­sure gra­di­ent is ­more ­than 8 mmHg or ­the pres­sure ­half-­time is ­more ­than 160 ­msec, ­there is a pos­sibil­ity of com­pli­ca­tions. Despite ­the prob­lems, ­the ­absence of ­any struc­tu­ral ­change ­after ­more ­than ­ten ­years sug­gests ­that ­the ­SJM ­valve ­can be ­used in ­the tri­cus­pid posi­tion ­with care­ful fol­low-up.

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