Normal reference values for mechanical mitral prosthetic valve inner diameters and areas assessed by two-dimensional and
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ORIGINAL PAPER
Normal reference values for mechanical mitral prosthetic valve inner diameters and areas assessed by two‑dimensional and real‑time three‑dimensional transesophageal echocardiography Macit Kalçık1 · Mehmet Özkan2,3 · Sabahattin Gündüz2 · Mustafa Ozan Gürsoy4 · Mahmut Yesin5 · Emrah Bayam2 · Ahmet Güner6 · Semih Kalkan2 · Süleyman Karakoyun5 · Halil İbrahim Tanboğa7 Received: 2 May 2020 / Accepted: 18 September 2020 © Springer Nature B.V. 2020
Abstract It was previously observed that two dimensional (2D) Doppler derived and real-time three-dimensional (RT-3D) directly measured valve areas were smaller than reported manufacturer sizes. It may be helpful to obtain the ranges of inner diameters (IDs) and the geometric orifice area (GOA) during evaluation of prosthetic mitral valves. In this study, we aimed to provide reference dimensional parameters of bileflet mitral mechanical prosthetic valves. Patients with recent mitral valve replacement were examined by 2D and RT-3D transesophageal echocardiography (TEE) in the early postoperative period when the presence of pannus overgrowth was unlikely. Measurements of 2D IDs, 3D hinge to hinge (HHD) and edge to edge diameters (EED) and 3D GOA were obtained and compared with reported manufacturer sizes and areas. This study enrolled 126 patients with mitral prosthetic valves (38 ATS, 42 Carbomedics, 46 St. Jude Medical, all bileaflet). The measured 2D and 3D IDs and GOA were significantly smaller than reported manufacturer sizes in the majority of the valve sizes. This RT-3D TEE-guided study provides ranges of reference values for directly measured IDs and GOA of the three most commonly used mechanical mitral prosthetic valve types for the first time in a relatively large series. Keywords Echocardiography · Inner diameter · Orifice area · Prosthetic valve · Transesophageal echocardiography
Introduction * Macit Kalçık [email protected] 1
Faculty of Medicine, Department of Cardiology, Hitit University, Buharaevler Mah. Buhara 25. Sok. No:1 /A Daire:22, Çorum, Turkey
2
Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
3
Division of Health Sciences, Ardahan University, Ardahan, Turkey
4
Department of Cardiology, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
5
Faculty of Medicine, Department of Cardiology, Kars Kafkas University, Kars, Turkey
6
Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
7
Faculty of Medicine, Department of Cardiology, Nisantasi University, Istanbul, Turkey
Prosthetic valve function is mainly assessed noninvasively by 2-dimensional (2D) transthoracic (TTE) and transesophageal echocardiography (TEE) techniques from which structural and hemodynamic information is derived [1]. The American Society of Echocardiography guidelines suggest several Doppler-derived parameters and thresholds for the evaluation of prosthetic valve function including mean and
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