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Revision as of 20:03, 4 January 2014

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(Created page with "==Mechanical prosthetic valves== {| class="wikitable" cellpadding="0" cellspacing="0" border="0" |- |+ Normal Values Mechanical Aortic Valve Art<cite>1</cite> |- !Valve !Typ...")
 
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==Mechanical prosthetic valves==
==Mechanical prosthetic valves==


{| class="wikitable" cellpadding="0" cellspacing="0" border="0"
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="800px"
|-
|-
|+ Normal Values Mechanical Aortic Valve Art<cite>1</cite>
|+ Normal Values Mechanical Aortic Valve Art<cite>1</cite>
Line 215: Line 215:
|rowspan="4" valign="top"|Medtronic Advantage
|rowspan="4" valign="top"|Medtronic Advantage
|rowspan="4" valign="top"|Bileaflet
|rowspan="4" valign="top"|Bileaflet
|23
|23
|
|10.4 ± 3.1
|10.4 ± 3.1
|2.2 ± 0.3
|2.2 ± 0.3
|-
|-
|25
|25
|
|9.0 ± 3.7
|9.0 ± 3.7
|2.8 ± 0.6
|2.8 ± 0.6
|-
|-
|27
|27
|
|7.6 ± 3.6
|7.6 ± 3.6
|3.3 ± 0.7
|3.3 ± 0.7
|-
|-
|29
|29
|
|6.1 ± 3.8
|6.1 ± 3.8
|3.9 ±0.7
|3.9 ±0.7
Line 260: Line 264:
|rowspan="5" valign="top"|Monostrut Bjork-Shiley
|rowspan="5" valign="top"|Monostrut Bjork-Shiley
|rowspan="5" valign="top"|Single tilting disc
|rowspan="5" valign="top"|Single tilting disc
|19
|19
|27.4 ± 8.8  
|
|27.4 ± 8.8
|  
|-
|-
|21
|21
|27.5 ± 3.1
|27.5 ± 3.1
|20.5 ± 6.2  
|20.5 ± 6.2
|  
|-
|-
|23
|23
|20.3 ± 0.7
|20.3 ± 0.7
|17.4 ± 6.4  
|17.4 ± 6.4
|  
|-
|-
|25
|25
|16.1 ± 4.9  
|
|16.1 ± 4.9
|  
|-
|-
|27
|27
|11.4 ± 3.8  
|
|11.4 ± 3.8
|  
|-
|-
|rowspan="4" valign="top"|Omnicarbon
|rowspan="4" valign="top"|Omnicarbon
Line 423: Line 435:
|26
|26
|31.8 ± 9.0
|31.8 ± 9.0
|19.7 ± 6.1  
|19.7 ± 6.1
|  
|-
|-
|27
|27
|30.8 ± 6.3
|30.8 ± 6.3
|18.5 ± 3.7  
|18.5 ± 3.7
|  
|-
|-
|29
|29
|29.0 ± 9.3
|29.0 ± 9.3
|16.3 ± 5.5
|16.3 ± 5.5
|
|}
|}


{| class="wikitable" cellpadding="0" cellspacing="0" border="0"
{| class="wikitable" cellpadding="0" cellspacing="0" border="0" width="800px"
|-
|-
|+ Normal Values Mechanical Mitral valve art
|+ Normal Values Mechanical Mitral valve art<cite>1</cite>
|-
|-
!Valve  
!Valve  
Line 443: Line 458:
!Peak gradient (mmHg)  
!Peak gradient (mmHg)  
!Mean gradient (mmHg)  
!Mean gradient (mmHg)  
!EOA (cm2)
!Peak Velocity (m/s)
!Pressure half-time (ms)
!width="100px"|EOA (cm2)
|-
|rowspan="5" valign="top"|Bjork-Shiley
|rowspan="5" valign="top"|Tilting disc
|23
|
|
|1.7
|115
|
|-
|25
|12 ± 4
|6 ± 2
|1.75 ± 0.38
|99 ± 27
|1.72 ± 0.6
|-
|27
|10 ± 4
|5 ± 2
|1.6 ± 0.49
|89 ± 28
|1.81 ± 0.54
|-
|29
|7.83 ± 2.93
|2.83 ± 1.27
|1.37 ± 0.25
|79 ± 17
|2.1 ± 0.43
|-
|31
|6 ± 3
|2 ± 1.9
|1.41 ± 0.26
|70 ± 14
|2.2 ± 0.3
|-
|rowspan="5" valign="top"|Bjork-Shiley monostrut
|rowspan="5" valign="top"|Tilting disc
|23
|
|5.0
|1.9
|
|
|-
|25
|13 ± 2.5
|5.57 ± 2.3
|1.8 ± 0.3
|
|
|-
|27
|12 ± 2.5
|4.53 ± 2.2
|1.7 ± 0.4
|
|
|-
|29
|13 ± 3
|4.26 ± 1.6
|1.6 ± 0.3
|
|
|-
|31
|14 ± 4.5
|4.9 ± 1.6
|1.7 ± 0.3
|
|
|-
|rowspan="6" valign="top"|Carbomedics
|rowspan="6" valign="top"|Bileaflet
|23
|
|
|1.9 ± 0.1
|126 ± 7
|
|-
|25
|10.3 ± 2.3
|3.6 ± 0.6
|1.3 ± 0.1
|93 ± 8
|2.9 ± 0.8
|-
|27
|8.79 ± 3.46
|3.46 ± 1.03
|1.61 ± 0.3
|89 ± 20
|2.9 ± 0.75
|-
|29
|8.78 ± 2.9
|3.39 ± 0.97
|1.52 ± 0.3
|88 ± 17
|2.3 ± 0.4
|-
|31
|8.87 ± 2.34
|3.32 ± 0.87
|1.61 ± 0.29
|92 ± 24
|2.8 ± 1.14
|-
|33
|8.8 ± 2.2
|4.8 ± 2.5
|1.5 ± 0.2
|93 ± 12
|
|-
|rowspan="4" valign="top"|Duromedics
|rowspan="4" valign="top"|Bileaflet
|27
|13 ± 6
|5 ± 3
|1.61 ± 0.4
|75 ± 12
|
|-
|29
|10 ± 4
|3 ± 1
|1.40 ± 0.25
|85 ± 22
|
|-
|31
|10.5 ± 4.33
|3.3 ± 1.36
|1.38 ± 0.27
|81 ± 12
|
|-
|33
|11.2
|2.5
|
|85
|
|-
|rowspan="4" valign="top"|Lillehei-Kaster
|rowspan="4" valign="top"|Tilting disc
|18
|
|
|1.7
|140
|
|-
|20
|
|
|1.7
|67
|
|-
|22
|
|
|1.56 ± 0.09
|94 ± 22
|
|-
|25
|
|
|1.38 ± 0.27
|124 ± 46
|
|-
|rowspan="3" valign="top"|Medtronic Hall
|rowspan="3" valign="top"|Tilting disc
|27
|
|
|1.4
|78
|
|-
|29
|
|
|1.57 ± 0.1
|69 ± 15
|
|-
|31
|
|
|1.45 ± 0.12
|77 ± 17
|
|-
|rowspan="6" valign="top"|Omnicarbon
|rowspan="6" valign="top"|Tilting disc
|23
|
|8.0
|
|
|
|-
|25
|
|6.05 ± 1.81
|1.77 ± 0.24
|102 ± 16
|
|-
|27
|
|4.89 ± 2.05
|1.63 ± 0.36
|105 ± 33
|
|-
|29
|
|4.93 ± 2.16
|1.56 ± 0.27
|120 ± 40
|
|-
|31
|
|4.18 ± 1.4
|1.3 ± 0.23
|134 ± 31
|
|-
|33
|
|4 ± 2
|
|
|
|-
|rowspan="5" valign="top"|On-X
|rowspan="5" valign="top"|Bileaflet
|25
|11.5 ± 3.2
|5.3 ± 2.1
|
|
|1.9 ± 1.1
|-
|27
|10.3 ± 4.5
|4.5 ± 1.6
|
|
|2.2 ± 0.5
|-
|29
|10.3 ± 4.5
|4.5 ± 1.6
|
|
|2.2 ± 0.5
|-
|31
|9.8 ± 3.8
|4.8 ± 2.4
|
|
|2.5 ± 1.1
|-
|33
|9.8 ± 3.8
|4.8 ± 2.4
|
|
|2.5 ± 1.1
|-
|rowspan="4" valign="top"|Sorin Allcarbon
|rowspan="4" valign="top"|Tilting disc
|25
|15 ± 0.25
|4 ± 0.5
|1.95 ± 0.02
|70 ± 1
|
|-
|27
|11 ± 2.75
|4 ± 0.5
|1.65 ± 0.21
|82 ± 20
|
|-
|29
|12 ± 3
|4 ± 1.25
|1.73 ± 0.22
|80 ± 14
|
|-
|31
|10 ± 1.5
|4 ± 1
|1.66 ± 0.11
|83 ± 14
|
|-
|rowspan="5" valign="top"|St. Jude Medical
|rowspan="5" valign="top"|Bileaflet
|23
|
|4.0
|1.5
|160
|1.0
|-
|25
|
|2.5 ± 1
|1.34 ± 1.12
|75 ± 4
|1.35 ± 0.17
|-
|27
|11 ± 4
|5 ± 1.82
|1.61 ± 0.29
|75 ± 10
|1.67 ± 0.17
|-
|29
|10 ± 3
|4.15 ± 1.8
|1.57 ± 0.29
|85 ± 10
|1.75 ± 0.24
|-
|31
|12 ± 6
|4.46 ± 2.22
|1.59 ± 0.33
|74 ± 13
|2.03 ± 0.32
|-
|rowspan="5" valign="top"|Starr-Edwards
|rowspan="5" valign="top"|Caged ball
|26
|
|10.0
|
|
|1.4
|-
|28
|
|7 ± 2.75
|
|
|1.9 ± 0.57
|-
|30
|12.2 ± 4.6
|6.99 ± 2.5
|1.7 ± 0.3
|125 ± 25
|1.65 ± 0.4
|-
|32
|11.5 ± 4.2
|5.08 ± 2.5
|1.7 ± 0.3
|110 ± 25
|1.98 ± 0.4
|-
|-
|rowspan="5" valign="top"|
|34
|
|5.0
|
|
|2.6
|}


|}
==Leakage==
There is slight insufficiency, in all of the mechanical prosthetic valves it is the flow that is needed to allow the valve can be closed and keep the valve free from clots. This flow is due to the hinges of the valve. The degree of leakage and lekpatroon is by design prosthetic valve depends. At a St Jude can sometimes five small flames are observed. TEE This leakage is generally low.
 
==Mitral regurgitation with prosthetic valve==
Hemodynamically significant (at least moderate) mitral regurgitation with prosthetic valves without obstruction. ( PHT <120 msec)
 
Peak inflow velocity > 1.9 m/s (CW - Doppler)
 
Peakgradiënt > 14 mmHg (CW - Doppler)
 
TVI MV inflow (CW - Doppler/TVI LVOT (PW Doppler) > 2.5
 
These measurements can help you on the spot. Alert pathological mitraliskunstklep leakage after further research is needed with TEE.
 
[[Image: Video]]
 
==Related valve dysfunction with mechanical prostheses==
Bjork- Shiley: strut fracture
 
Carbomedics: degeneration disc
 
Hancock bioprosthesis: Distortion stents causing stenosis
 
Carpentier Edwards bioprosthesis: tear/holes in leaflets and development of stenosis


==References==
==References==
Nilofer
0

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