Quantitative assessment of mechanical prosthetic valve area by 3-dimensional transesophageal echocardiography

Objective: The goal of this study was to assess the geometric orifice area of mechanical valve prostheses by transesophageal 3-dimensional echocardiog raphic planimetry. Methods and Results: Currently used Doppler methods for prosthetic assessme nt (orifice area-Doppler) were compared with 3D planimetry for orifice area (orifice area-3D) and with manufacturer's values (orifice area-manufacture r) for the corresponding prosthesis types and sizes and with historical con trols provided by Doppler literature (orifice area-literature). Twentyfour mechanical valve prostheses tin 22 patients were studied 13 in mitral posit ion and 11 in aortic position. Orifice area-manufacturer, orifice area- Dop pler, orifice area-literature, and orifice area-3D were 3.6 +/- 1.1 cm(2), 2.3 +/- 0.9 cm(2), 2.4 +/- 0.9 cm(2), and 2.6 +/- 0.7 cm(2), respectively. Orifice area-manufacturer values were significantly larger Correlation coef ficients between orifice area-3D and orifice area-manufacturer, and between orifice area-3D and orifice area-Doppler and orifice area-literature were 0.83, 0.90, and 0.73, respectively (all P < .0001). Conclusion: Three-dimensional transesophageal echocardiography is feasible and has good correlation with orifice area-Doppler (in aortic position) and good correlation with orifice area-manufacturer (in aortic and mitral posi tions) methods.