ACCELERATION TIME AND EJECTION TIME ARE NOT ACCURATE ECHOCARDIOGRAPHIC PARAMETERS TO IDENTIFY STRUCTURAL VALVE DETERIORATION IN AORTIC BIOPROSTHESIS

Abstract

Bioprosthesis used for aortic valve replacement (AVR) in aortic stenosis are subject to structural valve deterioration (SVD) after 20 years or less which leads to reintervention. The diagnostic of SVD can be challenging in the presence of patient-prosthesis mismatch (PPM) which occurs when the effective orifice area (EOA) of the BP is too small for the metabolic needs of a patient. Both SVD and PPM are mainly diagnosed with echocardiography and are characterized by high transaortic mean and peak pressure gradients (MG and PG) and maximal velocity (Vmax) as well as reduced EOA. Easily accessible parameters are needed to distinguish SVD from PPM. Systolic time intervals such as acceleration time (AT), ejection time (ET) and AT/ET have been proposed as accurate parameters to identify SVD is presence of PPM. However, these parameters need to be validated. The main goal of the present study is to determine the accuracy of systolic time intervals to identify SVD and to find and validate new echocardiographic parameters that can distinguish SVD from PPM. New echocardiographic parameters proposed for this study are MG/EOA and peak pressure gradient over transaortic mean flow rate (PG/Q).