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Hemodynamic assessment of carbomedics bileaflet heart valves by ultrasound: studies in the aortic and mitral positions. 1996

E G Cape, and H W Sung, and A P Yoganathan
Cardiac Dynamics Laboratory, Children's Hospital of Pittsburgh, University of Pittsburgh, PA, USA.

The bileaflet mechanical heart valve has become a popular prosthesis for implantation in both the aortic and mitral positions and a recent design by Carbomedics has received widespread use. Noninvasive assessment of these valves by Doppler ultrasound is important in characterizing their normal performance and in assessing the course of dysfunction. This study addressed the hypothesis that Doppler predicted pressure drops will correlate with catheter pressure drops within a valve size and position. A subhypothesis is that the pressure drops agree, and we expect this subhypothesis to fail due to pressure recovery effects. In a well-controlled in vitro model it was shown that the combined effects of pressure recovery and neglecting proximal velocities resulted in overestimation of catheter pressure drops for Carbomedics bileaflet valves. Inclusion of the proximal velocity reduced overestimation of peak pressure drops for aortic and mitral valves to clinically acceptable levels, and removed overestimation of mean pressure drops. Without correction for proximal velocity, overestimation of mitral pressure drops was reduced to 3.32% when means were calculated, but mean aortic pressure drops still overestimated the catheter standard significantly. It is concluded that proximal velocities should be included in Bernoulli analysis of Carbomedics heart valves. If the proximal velocity is not available, mitral valves may be best assessed using mean pressure drops, while aortic valve Doppler data, peak or mean, should be interpreted with caution.

UI MeSH Term Description Entries
D008943 Mitral Valve The valve between the left atrium and left ventricle of the heart. Bicuspid Valve,Bicuspid Valves,Mitral Valves,Valve, Bicuspid,Valve, Mitral,Valves, Bicuspid,Valves, Mitral
D008953 Models, Anatomic Three-dimensional representation to show anatomic structures. Models may be used in place of intact animals or organisms for teaching, practice, and study. Anatomic Models,Models, Surgical,Moulages,Models, Anatomical,Anatomic Model,Anatomical Model,Anatomical Models,Model, Anatomic,Model, Anatomical,Model, Surgical,Moulage,Surgical Model,Surgical Models
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D006350 Heart Valve Prosthesis A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material. Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001021 Aortic Valve The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. Aortic Valves,Valve, Aortic,Valves, Aortic
D018608 Ultrasonography, Doppler Ultrasonography applying the Doppler effect, with frequency-shifted ultrasound reflections produced by moving targets (usually red blood cells) in the bloodstream along the ultrasound axis in direct proportion to the velocity of movement of the targets, to determine both direction and velocity of blood flow. (Stedman, 25th ed) Doppler Ultrasonography,Doppler Ultrasound,Doppler Ultrasound Imaging,Doppler Ultrasound Imagings,Doppler Ultrasounds,Imaging, Doppler Ultrasound,Imagings, Doppler Ultrasound,Ultrasound Imaging, Doppler,Ultrasound Imagings, Doppler,Ultrasound, Doppler,Ultrasounds, Doppler

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