Prosthetic valve evaluation is one of the difficult echocardiographic tasks. The metallic structures within the valve cause a lot of acoustic shadowing and artefacts. Poppet excursion is an index of valve function. Paravalvar leaks can be evaluated by Doppler studies. Obstruction can be evaluated by assessing the trans valvar gradients. Normal gradients for each type of valve is different and has to be considered before suspecting prosthetic valve obstruction. Undue movement of the prosthesis may suggest instability of the valve.
Prosthetic Mitral Valve seen in Apical Four Chamber View
Prosthetic Mitral Valve in Parasternal Long Axis View
The turbulent jet in left ventricular out flow tract (LVOT) is caused by the projection of the prosthesis into the LVOT. This may cause significant LVOT gradient if a high profile valve is implanted in a small ventricle as in mitral stenosis.
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