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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 June;164(3):227-9

language: English

Early detection of valve dysfunction by digital phonocardiograhpy

Reber C. 1, Fritz M. 1, Helm C. 1, Brensing A. 2, Laczkovics A. 1

1 Ruhr-University Bochum, Department of Cardiothoracic Surgery Bergmannsheil University Hospital, Bochum, Germany;
2 Cardiosignal, Hamburg, Germany


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Dysfunction of mechanical valves due to thrombosis is a life-threatening complication. Early detection can be life saving. DP(digital phonocardiography) is a new tool especially designed to record and analyze ultrasound frequencies above 8 kHz. Evaluation of valve function relies upon analysis of the acoustic signal at the time of valve opening and closure. A 73 year old lady presented herself spontaneously because of the change of the sound of her aortic valve. She had been operated on 10yrs ago, having a bileaflet mechanical St Jude Medical valve. At the time of investigation using DP, a 25% drop in resonance frequency compared with the measurements after reoperation could be detected. Also, preoperatively one leaflet did not show up in the recording, whereas the other leaflet sounded normal. The time interval between leaflet closures was significantly shortened before reoperation. At the reoperation a clot of thrombus was lodged on the leaflet and could be meticulously removed. Postoperatively, the expected values in resonance frequency, acoustic energy and time interval between leaflet movements could be observed. The hypothesis, that any change of a characteristic ultrasound profile after implantation of a mechanical valve is suspicious of dysfunction could be proven. DP is a promising, simple and non invasive method of early detection of mechanical valve dysfunction even before clinical or echocardiographic evidence.

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