CHARACTERIZATION OF NORMAL LEAKAGE FLOW OF MONOSTRUT TILTING DISK PROSTHETIC MITRAL-VALVES BY MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHY

To assess normal prosthetic mitral valve function, multiplane transeso phageal Doppler echocardiographic studies were performed on 22 patient s with Monostrut tilting disk valves. Mean follow-up after implantatio n was 63 +/- 12 months. Two holosystolic red low-velocity regurgitant jets were detected in all but one case. The length of these jets range d from 0.8 to 6.9 cm and the area ranged from 0.5 to 10.1 cm(2) in var ious planes. The origin of the jets was inside the rings of the prosth etic valves and started with a mosaic spot of 2 mm maximum diameter. I n this mosaic spot, jet velocity by the high pulse-repetition frequenc y mode measured greater than 4 m/sec. Thin, high-velocity regurgitant jets originating outside the serving ring were present in three cases. In one case we found a high-velocity turbulent jet originating outsid e the ring corresponding to a paravalvular regurgitation of moderate d egree. The low-velocity jets were obscured in the patient with moderat e paravalvular teak but not in patients with trivial paravalvular leak s.