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Evaluation of St. Jude Medical Mitral Valve Function by Exercise Doppler Echocardiography
Author(s) -
Shigenobu Masaharu,
Sano Shunji
Publication year - 1995
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.1995.tb01234.x
Subject(s) - medicine , cardiology , mitral valve , doppler echocardiography , doppler effect , diastole , blood pressure , physics , astronomy
The aim of this study was to detect borderline mitral valve dysfunction in 100 asymptomatic patients with a St. Jude Medical valve. We studied rest and exercise hemodynamics by Doppler echocardiography. Study patients were divided into two groups according to the time since surgery: group A had valves implanted less than 5 years ago (44 patients), group B had valves implanted more than 5 years ago (56 patients). Although patients had no clinical signs of valve dysfunction, group B was found to have significant reduction of mitral valve area (p < 0.05). In the group A patients, mean gradients at rest increased from 4 ± 2, 4 ± 2, and 3 ± 1 mmHg in valve sizes of 25, 27, and 29 mm, respectively, to 7 ± 2, 7 ± 3, and 5 ± 2 mmHg with exercise. In the group B patients, mean gradients at rest increased from 7 ± 1, 6 ± 2, and 5 ± 1 mmHg to 14 ± 3, 13 ± 3, and 10 ± 4 mmHg, respectively, after exercise. The percent increase (mean) in peak pressure gradient with exercise was significantly higher in group B (more than 100%) than in group A (less than 80%) (p < 0.01). The percent increase in mean gradient with exercise was also significantly higher in group B (more than 100%) than in group A (less than 75%). In conclusion, patients with reduced valve area and more than a 100% increase of peak and mean gradients should be followed up carefully. If any signs or symptoms of heart failure develop, they must be considered as candidates for surgery.