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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 449: Line 449:
|}
|}


{| 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 485: Line 485:
|1.81 ± 0.54
|1.81 ± 0.54
|-
|-
|29 7.83 ± 2.93 2.83 ± 1.27 1.37 ± 0.25 79 ± 17 2.1 ± 0.43
|29
|31 6 ± 3 2 ± 1.9 1.41 ± 0.26 70 ± 14 2.2 ± 0.3
|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"|Bjork-Shiley monostrut
|rowspan="5" valign="top"|Tilting disc
|rowspan="5" valign="top"|Tilting disc
|23
|23
|
|5.0
|5.0
|1.9
|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  
|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"|Carbomedics
|rowspan="6" valign="top"|Bileaflet
|rowspan="6" valign="top"|Bileaflet
|23
|23
|
|
|1.9 ± 0.1
|1.9 ± 0.1
|126 ± 7  
|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
|25
|31 8.87 ± 2.34 3.32 ± 0.87 1.61 ± 0.29 92 ± 24 2.8 ± 1.14
|10.3 ± 2.3
|33 8.8 ± 2.2 4.8 ± 2.5 1.5 ± 0.2 93 ± 12
|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"|Duromedics
Line 516: Line 587:
|1.61 ± 0.4
|1.61 ± 0.4
|75 ± 12  
|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  
|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"|Lillehei-Kaster
|rowspan="4" valign="top"|Tilting disc
|rowspan="4" valign="top"|Tilting disc
|18
|18
|
|
|1.7
|1.7
|140
|140
|20 1.7 67
|
|22 1.56 ± 0.09 94 ± 22
|-
|25 1.38 ± 0.27 124 ± 46  
|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"|Medtronic Hall
|rowspan="3" valign="top"|Tilting disc
|rowspan="3" valign="top"|Tilting disc
|27
|27
|
|
|1.4
|1.4
|78  
|78
|29
|
|-  
|29
|
|
|1.57 ± 0.1
|1.57 ± 0.1
|69 ± 15
|69 ± 15
|31 1.45 ± 0.12 77 ± 17
|
|-
|31
|
|
|1.45 ± 0.12
|77 ± 17
|
|-
|-
|rowspan="6" valign="top"|Omnicarbon
|rowspan="6" valign="top"|Omnicarbon
|rowspan="6" valign="top"|Tilting disc
|rowspan="6" valign="top"|Tilting disc
|23
|23
|8.0  
|
|25 6.05 ± 1.81 1.77 ± 0.24 102 ± 16  
|8.0
|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
|-  
|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"|On-X
Line 553: Line 711:
|25
|25
|11.5 ± 3.2
|11.5 ± 3.2
|5.3 ± 2.1
|5.3 ± 2.1
|
|
|1.9 ± 1.1
|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
|27
|31 9.8 ± 3.8 4.8 ± 2.4 2.5 ± 1.1
|10.3 ± 4.5
|33 9.8 ± 3.8 4.8 ± 2.4 2.5 ± 1.1
|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"|Sorin Allcarbon
Line 566: Line 750:
|4 ± 0.5
|4 ± 0.5
|1.95 ± 0.02
|1.95 ± 0.02
|70 ± 1  
|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
|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"|St. Jude Medical
|rowspan="5" valign="top"|Bileaflet
|rowspan="5" valign="top"|Bileaflet
|23
|23
|
|4.0
|4.0
|1.5
|1.5
|160
|160
|1.0
|1.0
|25
|-
|25
|
|2.5 ± 1
|2.5 ± 1
|1.34 ± 1.12
|1.34 ± 1.12
|75 ± 4
|75 ± 4
|1.35 ± 0.17
|1.35 ± 0.17
|-
|27
|27
|11 ± 4
|11 ± 4
Line 589: Line 796:
|75 ± 10
|75 ± 10
|1.67 ± 0.17
|1.67 ± 0.17
|-
|29
|29
|10 ± 3
|10 ± 3
Line 595: Line 803:
|85 ± 10
|85 ± 10
|1.75 ± 0.24
|1.75 ± 0.24
|-
|31
|31
|12 ± 6
|12 ± 6
Line 607: Line 816:
|
|
|10.0
|10.0
|
|
|
|1.4
|1.4
|28
|-
|7 ± 2.75
|28
|
|7 ± 2.75
|
|
|1.9 ± 0.57
|1.9 ± 0.57
|-
|30
|30
|12.2 ± 4.6
|12.2 ± 4.6
Line 618: Line 833:
|125 ± 25
|125 ± 25
|1.65 ± 0.4
|1.65 ± 0.4
|-
|32
|32
|11.5 ± 4.2
|11.5 ± 4.2
Line 624: Line 840:
|110 ± 25
|110 ± 25
|1.98 ± 0.4
|1.98 ± 0.4
|34
|-
|5.0
|34
|
|5.0
|
|
|2.6
|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
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