[The Duromedics mitral valve mechanical prosthesis: evaluation by means of transesophageal echocardiography].

We investigated via transesophageal echocardiography 29 patients with Duromedics mitral prosthesis to define the characteristics of normal and abnormal functioning valves as well as the advantages of this study compared to transthoracic echocardiography. The clinical and transthoracic examination identified three groups. The first group consisted of 8 patients with abnormal hemodynamic parameters (maximal velocity 245.5 +/- 38.4 cm/sec, maximal gradient 24.6 +/- 7.9 mmHg, medium gradient 9.8 +/- 0.8 mmHg, pressure half time 121.6 +/- 58.8 msec, valvular area 2.1 +/- 0.8 cm2). In 4 cases we detected a paravalvular regurgitant jet. The second group was formed of 12 symptomatic patients, with normal hemodynamic parameters (maximal velocity 169.1 +/- 20.1, maximal gradient 11.6 +/- 2.5, medium gradient 4.8 +/- 1.8, pressure half time 118 +/- 18 msec, valvular area 1.9 +/- 2.8 cm2). In 4 cases we detected a paravalvular regurgitant jet. The third group was formed by 9 asymptomatic patients with normal hemodynamic parameters: maximal velocity 160.6 +/- 26.6, maximal gradient 10.5 +/- 3.3, medium gradient 4 +/- 1, pressure half time 118 +/- 40, valvular area 2 +/- 0.5. We did not observe a regurgitant jet in any of these patients. Transesophageal echocardiography detected a paravalvular jet in all patients of the first group, with an area of 6.9 +/- 5.8 cm2; in the second group it demonstrated one or two valvular jets, with a maximal area of 5.1 +/- 3.2 cm2. Furthermore, it defined as valvular, the site of a jet previously described as paravalvular with the transthoracic examination.(ABSTRACT TRUNCATED AT 250 WORDS)