Abstract

CIANCIULLI, Tomás F et al. Cinefluoroscopic Assessment of Five Models of Single-leaflet Mechanical Heart Valve Prosthesis Implanted in the Argentine Republic: Its Value as a Complementary Method to Color Doppler Echocardiography. Rev. argent. cardiol. [online]. 2008, vol.76, n.1, pp.42-46. ISSN 1850-3748.

Many types of mechanical prosthesis are used for heart valve replacement, but it is difficult to distinguish between them using transthoracic echocardiography. Cinefluoroscopy (CF) may complement the echocardiographic evaluation of cardiac prosthesis. Objectives 1) To describe the contribution of cinefluoroscopy in identifying different prosthesis. 2) To assess heart valve prosthesis functioning comparing gradients obtained by Doppler echocardiography with the opening angle of the disc got by CF. 3) To recognize the ability of CF in the assessment of normal versus dysfunctional cardiac prosthesis. Material and Methods Ninety four cardiac prosthesis (53 in aortic position and 41 in mitral position) were prospectively assessed by echo-Doppler and cinefluoroscopy. Results Cinefluoroscopy was able to identify 100% of prosthesis. Disc motion assessment could differentiate between normal and dysfunctional prosthesis. Echo-Doppler exam revealed that 22 aortic prosthesis and 21 mitral prosthesis were normal. Fluoroscopic sensitivity and specificity to distinguish between normal and malfunctioning prosthesis were 90% and 81%, respectively. Conclusions 1) Cinefluoroscopy allows identifying each model of singleleaflet prosthesis. 2) Cinefluoroscopy distinguishes between a normal and a dysfunctional prosthesis. 3) Fluoroscopy is superior to echo-Doppler to assess disc motion, while echo- Doppler allows the measurement of gradients and areas, and the semi quantification of regurgitation. Thus, both methods should be considered complementary.

Keywords : Heart Valve Disease; Heart Valve Prosthesis; Echocardiography; Fluoroscopy.

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