Keser Nurgül, Nanda Navin C, Miller Andrew P, Voros Szilard, Soydas Cahide, Agrawal Gopal, Liguori Chiara, Naftel David, Pacifico Albert D, Kirklin James K, McGiffin David C, Holman William L
Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, AL, USA.
Ultrasound Med Biol. 2003 May;29(5):649-57. doi: 10.1016/s0301-5629(02)00777-9.
The Sulzer Carbomedics prosthetic heart valve (CP) is a commonly used mechanical valve in clinical practice. In the present study, we used conventional and color Doppler echocardiography to assess the hemodynamics of normally functioning CP in the aortic (n = 73) and mitral (n = 127) positions. Our findings demonstrate no significant correlation of Doppler-measured peak and mean pressure gradients and effective orifice area with implanted valve size and actual orifice areas, measured directly by the manufacturer for CPs in both the mitral and aortic positions. However, it is still useful to measure effective orifice area by Doppler because a value in the normal or nonstenotic range points to an unobstructed prosthesis in the aortic or mitral position, in the absence of poor left ventricular ejection fraction. A value in the stenotic range could mean a normally functioning or obstructed prosthesis and, therefore, may need further investigation, such as assessment of valve leaflet motion by transthoracic or transesophageal echocardiography or fluoroscopy. Valve regurgitation as evaluated by color Doppler flow mapping was mild in practically all CPs in the aortic position, and in the majority of CPs in the mitral position.
苏尔寿卡博梅迪克斯人工心脏瓣膜（CP）是临床实践中常用的机械瓣膜。在本研究中，我们使用传统和彩色多普勒超声心动图评估了主动脉瓣位（n = 73）和二尖瓣位（n = 127）功能正常的CP的血流动力学。我们的研究结果表明，对于二尖瓣位和主动脉瓣位的CP，通过多普勒测量的峰值和平均压力阶差以及有效瓣口面积与植入瓣膜尺寸和制造商直接测量的实际瓣口面积之间无显著相关性。然而，通过多普勒测量有效瓣口面积仍然有用，因为在左心室射血分数正常的情况下，正常或无狭窄范围内的值表明主动脉瓣位或二尖瓣位的人工瓣膜无梗阻。狭窄范围内的值可能意味着人工瓣膜功能正常或有梗阻，因此可能需要进一步检查，如通过经胸或经食管超声心动图或荧光透视评估瓣膜叶运动。通过彩色多普勒血流显像评估的瓣膜反流在几乎所有主动脉瓣位的CP中为轻度，在大多数二尖瓣位的CP中也为轻度。
