Abstract
There are 2 main causes of sudden unexpected heart failure immediately after mitral valve replacement with the Björk-Shiley prosthetic valve: mechanical malfunction of the prosthetic valve 1–4 and myocardial dysfunction. It is necessary to differentiate the two because the required counter-measures differ greatly. Between March 1982 and December 1988, we performed intraoperative epicardial echocardiography to compare valvular and myocardial function before and after cardiopulmonary bypass in 272 patients. We describe here the first documented intraoperative use of epicardial echocardiography to differentiate myocardial from prosthetic valvular dysfunction immediately after weaning the patient from cardiopulmonary bypass following mitral valve replacement with the Björk-Shiley prosthetic valve.
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