Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses

Bogunovic N, Horstkotte D, Faber L, Bogunovic L, Kececioglu D, Piper C, Prinz C, van Buuren F (2012)
Echocardiography 29(6): 713-719.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
Download
Es wurden keine Dateien hochgeladen. Nur Publikationsnachweis!
Autor*in
Bogunovic, Nikola; Horstkotte, Dieter; Faber, Lothar; Bogunovic, LukasUniBi; Kececioglu, Deniz; Piper, Cornelia; Prinz, Christian; van Buuren, Frank
Abstract / Bemerkung
Background: Dysfunction of heart valve prostheses (VP) is a life-threatening complication and the diagnosis remains difficult. The motivation for this study was to improve the detection of dysfunctional VP by optimizing application of the prosthetic effective orifice area (VA). For this reason the minimal expected normal VA (VAexpected) was introduced. Methods: We investigated echocardiographically 1,369 normally functioning aortic valve prostheses (AVP). Mean VA, transprosthetic peak (PPG) and mean pressure gradients (MPG) were evaluated to gain reference values depending on prosthetic size and construction principle. Mean VAexpected was calculated by applying a simple formula that was developed empirically using statistical analyses. The results were compared with those of 65 dysfunctional AVPs. Results: VAexpected can be applied as a threshold between normal and dysfunctional stenotic AVP and showed a correct estimation in 87% of all normally functioning and 100% of dysfunctional stenotic VPs. The sensitivity for all prosthetic sizes is 1.0, independently of the constructional principle of the VP. Specificity ranged between 0.8 and 1.0, dependent on VP size. The formula representing VAexpected is simple and can be executed easily. Conclusion: As nearly independent of stroke volume and in consideration of VAexpected, VA seems to have become one of the preferable parameters for detecting pathological stenotic AVPs echocardiographically. The additional application of PPG/MPG and other parameters permits prostheses with relevant isolated regurgitation and patient-prosthesis-mismatch to be distinguished. (Echocardiography 2012;29:713-719)
Stichworte
echocardiography; diagnosis; hemodynamics; valve prosthesis; opening area; effective
Erscheinungsjahr
2012
Zeitschriftentitel
Echocardiography
Band
29
Ausgabe
6
Seite(n)
713-719
ISSN
0742-2822
Page URI
https://pub.uni-bielefeld.de/record/2523769

Zitieren

Bogunovic N, Horstkotte D, Faber L, et al. Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses. Echocardiography. 2012;29(6):713-719.
Bogunovic, N., Horstkotte, D., Faber, L., Bogunovic, L., Kececioglu, D., Piper, C., Prinz, C., et al. (2012). Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses. Echocardiography, 29(6), 713-719. doi:10.1111/j.1540-8175.2011.01659.x
Bogunovic, Nikola, Horstkotte, Dieter, Faber, Lothar, Bogunovic, Lukas, Kececioglu, Deniz, Piper, Cornelia, Prinz, Christian, and van Buuren, Frank. 2012. “Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses”. Echocardiography 29 (6): 713-719.
Bogunovic, N., Horstkotte, D., Faber, L., Bogunovic, L., Kececioglu, D., Piper, C., Prinz, C., and van Buuren, F. (2012). Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses. Echocardiography 29, 713-719.
Bogunovic, N., et al., 2012. Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses. Echocardiography, 29(6), p 713-719.
N. Bogunovic, et al., “Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses”, Echocardiography, vol. 29, 2012, pp. 713-719.
Bogunovic, N., Horstkotte, D., Faber, L., Bogunovic, L., Kececioglu, D., Piper, C., Prinz, C., van Buuren, F.: Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses. Echocardiography. 29, 713-719 (2012).
Bogunovic, Nikola, Horstkotte, Dieter, Faber, Lothar, Bogunovic, Lukas, Kececioglu, Deniz, Piper, Cornelia, Prinz, Christian, and van Buuren, Frank. “Effective Valve Opening Area in the Detection of Dysfunctional Aortic Valve Prostheses: A Differentiated Statistical Analysis of This Parameter Including the Introduction of Minimal Expected Normal Values as Borderline to Dysfunctional Stenotic Prostheses”. Echocardiography 29.6 (2012): 713-719.

1 Zitation in Europe PMC

Daten bereitgestellt von Europe PubMed Central.

30 References

Daten bereitgestellt von Europe PubMed Central.

Recommendations for reporting morbid events after heart valve surgery
Horstkotte, J Heart Valve Dis 14(), 2005
Reference Doppler echocardiographic values for St. Jude Medical, Omnicarbon, and Biocor prosthetic valves in the aortic position
Bech-Hanssen, J Am Soc Echocardiogr 11(), 1998
Doppler echocardiography in normally functioning replacement aortic valves: A review of 129 studies
Rajani, J Heart Valve Dis 16(), 2007
Normal values for Doppler echocardiographic assessment of heart valve prostheses
Rosenhek, J Am Soc Echocardiogr 16(), 2003
Echo/Doppler evaluation of hemodynamics after aortic valve replacement. Principles of interrogation and evaluation of high gradients
Bach, JACC Cardiovasc Imaging 3(), 2010
Prevalence of pannus formation after aortic valve replacement: Clinical aspects and surgical management
Sakamoto, J Artif Organs 9(), 2008
Obstruction of St. Jude medical valves in the aortive position: A consideration for pathogenic mechanism of prosthetic valve obstruction
Aoyagi, Cardiovasc Surg 10(), 2002
Limitations and pitfalls in the assessment of prosthetic valves with Doppler ultrasonography
Chambers, J Thorac Cardiovasc Surg 104(), 1992
Early Doppler-echocardiography evaluation of 597 prosthetic aortic valves.
Minardi G, Pino PG, Manzara CC, Pulignano G, Viceconte GN, Stefanini GG, Gaudio C, Musumeci F., J Cardiovasc Med (Hagerstown) 11(4), 2010
PMID: 20090552
Normal values of prosthetic valve Doppler echocardiographic parameters: A review
Reisner, J Am Soc Echocardiogr 3(), 1988
Doppler echocardiography in normally functioning replacement heart valves: A literature review
Wang, J Heart Valve Dis 4(), 1995
Doppler assessment of prosthetic valve orifice area. An in vitro study
Baumgartner, Circulation 85(), 1992
Discrepancies between Doppler and catheter gradients in aortic prosthetic valves in vitro. A manifestation of localized gradients and pressure recovery
Baumgartner, Circulation 82(), 1990
Hemodynamic evaluation by Doppler echocardiography of small (≤21 mm) prostheses and bioprostheses in the aortic valve position
Wiseth, Am J Cardiol 70(), 1992
Echocardiographic assessment of prosthetic valves
Nanda, Circulation (Suppl I), 1984
Doppler echocardiography assessment of prosthetic heart valve
Grigg, Echocardiography 7(), 1990
Recommendations for evaluation of prosthetic valves with echocardiography and Doppler ultrasound
Zoghbi, J Am Soc Echocardiogr 22(), 2009
Recommendations for post-discharge patient follow-up after cardiac valve interventions: A position paper
Horstkotte, J Heart Valve Dis 16(), 2007
Recommendations for the management of prosthetic valve thrombosis.
Lengyel M, Horstkotte D, Voller H, Mistiaen WP; Working Group Infection, Thrombosis, Embolism and Bleeding of the Society for Heart Valve Disease., J. Heart Valve Dis. 14(5), 2005
PMID: 16245493
Limitations in the applicability of the simplified Bernoulli relation to aortic stenosis
Carey, Echocardiography 11(), 1994
Errors in pressure gradient measurement in prosthetic aortic valves due to pressure recovery
Stewart, Echocardiography 11(), 1994
Quantitative assessment of lumen area stenosis by Doppler echocardiography and application of continuity equation
Yamagishi, Echocardiography 11(), 1994
Errors in pressure gradient measurement by continuous wave Doppler ultrasound: Type, size and age effects in bioprosthetic aortic valves
Stewart, J Am Coll Cardiol 18(), 1991
Substitution of left ventricular outflow tract diameter with prosthesis size is inadequate for calculation of the aortic prosthetic valve area by the continuity equation
Pibarot, J Am Soc Echocardiogr 8(), 1995
Patient-prosthesis mismatch can be predicted at the time of operation
Pibarot, Ann Thorac Surg 71(), 2001
Prediction of valve prosthesis-patient mismatch prior to aortic valve replacement: Which is the best method?
Bleiziffer, Heart 93(), 2007
Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: Final reports of the Veterans Affairs randomized trial
Hammermeister, J Am Coll Cardiol 36(), 2000
Prosthetic heart valves: Selection of the optimal prosthesis and long-term management
Pibarot, Circulation 119(), 2009
3D Transesophageal echocardiographic guidance and monitoring of percutaneous aortic valve replacement.
Filgueiras-Rama D, Lopez T, Moreno-Gomez R, Calvo-Orbe L, Dobarro D, Moreno-Yanguela M, Lefevre T, Lopez-Sendon JL., Echocardiography 27(1), 2009
PMID: 20030688
Intraoperative real time three-dimensional transesophageal echocardiographic measurement of hemodynamic, anatomic and functional changes after aortic valve replacement.
Scohy TV, Soliman OI, Lecomte PV, McGhie J, Kappetein AP, Hofland J, Ten Cate FJ., Echocardiography 26(1), 2008
PMID: 19054036
Export

Markieren/ Markierung löschen
Markierte Publikationen

Open Data PUB

Web of Science

Dieser Datensatz im Web of Science®
Quellen

PMID: 22348380
PubMed | Europe PMC

Suchen in

Google Scholar