The Contribution of Echocardiography in the Dysfunctions of Mechanical Prosthesis: Report of 11 Cases

Abstract

Introduction: The echocardiography has an essential place in the surveillance of prostheses. The aim of our study was to describe the echocardiography aspects of dysfunction of valvular prostheses. Materials and methods: This is a retrospective study, which collected all patients admitted for dysfunction of mechanical prosthesis bileaflet in the cardiology department of Marrakech during a period of 2 years. Results: We included 11 patients. The mean age was 43 years. Seven cases were carrying a mitral prosthesis, 3 patients with aortic prosthesis and one case a double valve. The average age of prostheses was 3.7years. All prosthesis was an ON-X type. The prosthesis dysfunction was revealed by an infectious syndrome (27%), acute heart failure (18%), ischemic stroke (18%), while 36% were asymptomatic. The Transthoracic Echocardiography (TTE) was pathological in 10 cases: a reduction in the functional surface prostheses with increased transprosthetic gradient (54%) significant par prosthetic leak (45%), a thrombus in one case, an anomaly of the movements of leaflet (18%). The Echo-Transesophageal (TEE) made in 8 patients, objectified images of thrombi (3 cases), Para prosthetic leaks (6 patients), abnormal of the movements of leaflet (4 cases). Conclusion: Echocardiography is the gold standard for the diagnosis of prosthetic dysfunction with superiority of TEE over TTE. Keywords: Dysfunction; Mechanical prosthesis bileaflet; Echocardiography; Valvular prosthesis; Mitral prosthesis. Abbreviation: DVI : Doppler Velocity Index EOA : Effective Orifice Area EROA : Effective Regurgitantorifice Area LV : Left Ventricular LVOT : Left Ventricular Outflow Tract MPG : Mean Pressure Gradient PHT : Pression Half Time PHV : Prosthetic Heart Valves R Vol : Regurgitant Volume TEE : Transesophageal Echocardiography TTE : Transthoracic Echocardiography TVI : Time velocity Integral VC : Vennacontracta