News | September 01, 2009

New Guidelines for Prosthetic Valve Evaluation Presented by American Society of Echocardiography

September 1, 2009 – Echocardiography with Doppler is the method of choice for the noninvasive evaluation of prosthetic valves, according to a new guideline document in the September issue of the Journal of the American Society of Echocardiography (JASE).

The document offers a review of echocardiographic and Doppler techniques used in the assessment of prosthetic valves, and provides recommendations and general guidelines for evaluation of prosthetic valve function, based on the scientific literature and consensus of an international panel of experts. The guidelines have been endorsed by five prominent health organizations, including the American Heart Association, American College of Cardiology, European Association of Echocardiography, Japanese Society of Echocardiography, and the Canadian Society of Echocardiography.

“Over the last 40 years, a large variety of prosthetic valves have been developed with the aim of improving blood flow function, increasing durability and reducing complications,” said Dr. William A. Zoghbi, of Methodist DeBakey Heart and Vascular Center, Houston, Texas, and a lead author of the article. “Nevertheless, there is no ideal valve and all prosthetic valves are prone to dysfunction. The guidelines are critical to handling the evaluation of prosthetic valves and emphasize the importance of echocardiography.”

In patients with significant valvular stenosis or regurgitation, an intervention on the valve with either repair, valvuloplasty or valve replacement is inevitable. While valve repair is now frequently performed, especially for mitral and tricuspid regurgitation, valve replacement remains common, particularly in adults. This enlarging cohort may be difficult to assess. Symptoms may be nonspecific making it difficult to differentiate the effects of prosthetic valve dysfunction from ventricular dysfunction, pulmonary hypertension, pathology of the remaining native valves or noncardiac conditions.

“Although the physical examination can alert the clinician to the presence of significant prosthetic valve dysfunction, diagnostic methods are often needed to assess the function of the prosthesis,” said Dr. Zoghbi.

The recommendations outline the importance of a comprehensive evaluation for optimal assessment of prosthetic valve function. This includes obtaining pertinent clinical information such as date of valve replacement; type and size of the prosthetic valve; height/weight/body surface area; symptoms; and related clinical findings, blood pressure and heart rate.

Additionally, imaging of the valve from multiple views is recommended with particular attention to motion of leaflets or occluder, presence of calcification on the leaflets or abnormal echo density on the various components of the prosthesis, and valve sewing ring integrity and motion.

The guidelines stress the importance of Doppler echocardiography of the valve to evaluate some of the following parameters:
• Contour of the jet velocity signal
• Peak velocity and gradient
• Mean pressure gradient
• Velocity-time integral of the jet
• Doppler velocity index

Finally, the guidelines offer considerations for the intraoperative patient, other techniques for assessing replacement heart valves and considerations for early versus late complications of prosthetic valves.

The full ASE Guideline Document, “Recommendations for Evaluation of Prosthetic Valves with Echocardiography and Doppler Ultrasound” is available at

Related Content

Toshiba Medical Rolls Out Interactive Learning Tools for Ultrasound and Vascular Training
News | Ultrasound Imaging | December 04, 2017
Toshiba Medical, a Canon Group company, introduced new educational tools and interactive learning resources to help...
Toshiba Medical's Portable Ultrasound Used in Second Pediatric Mission in Tanzania
News | Ultrasound Imaging | October 05, 2017
October 5, 2017 — To provide lifesaving surgical care for sick children in one of the most underserved countries, 13
Clarius Wireless Ultrasound Scanners Now Available With Advanced Features
News | Ultrasound Imaging | August 09, 2017
Clarius Mobile Health has released advanced features and options for its wireless handheld ultrasound scanner for...
Oregon Tech Partners with Mindray for High-Tech Ultrasound Education
News | Ultrasound Imaging | August 04, 2017
To better prepare its ultrasound students to compete and thrive in the evolving healthcare environment, Oregon...
News | Ultrasound Imaging | March 28, 2017
Young rabbits exposed to ultrasound during fetal development had weaker thighbones than unexposed rabbits, according to...
ultrasound systems market, $5 billion, 2023, GlobalData report
News | Ultrasound Imaging | January 25, 2017
The ultrasound systems space, which covers 39 major markets, is set to rise steadily from $4.2 billion in 2016 to $5...
GE Healthcare, Vscan Extend, app-based ultrasound, dual-probe, RSNA 2017
Technology | Ultrasound Imaging | January 12, 2017
GE Healthcare unveiled its new generation of pocket-sized, dual-probe ultrasound, the Vscan Extend. From the hospital...
Toshiba, Aplio 500 Platinum ultrasound, International Contrast Ultrasound Society, ICUS, live case, contrast-enhanced ultrasound
News | Ultrasound Imaging | September 07, 2016
September 7, 2016 — Toshiba America Medical Systems Inc.
best ultrasound technician schools, 2016 ranking, College Choice
News | Ultrasound Imaging | August 22, 2016
August 22, 2016 — College Choice, a leading authority in college and university rankings and resources, has published
ContextVision, US PLUSView ultrasound enhancement software, iOS
Technology | Ultrasound Imaging | July 11, 2016
ContextVision has signed a contract to bring its US PLUSView ultrasound image enhancement software to hand-held iOS-...
Overlay Init