Download Free Medical Echocardiographic Evaluation of Prosthetic Cardiac Valves PowerPoint Presentation

Echocardiographic Evaluation of Prosthetic Cardiac Valves PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Echocardiographic Evaluation Of Prosthetic Cardiac Valves" by Dr Gaurav Kumar Chaudhary MD,DM( Cardiology).

This medical PowerPoint presentation talks about echocardiography as an important tool for evaluating the function and structure of prosthetic cardiac valves. It allows for non-invasive assessment of valve function and can help detect any potential problems before they become more serious.

Echocardiography is a non-invasive imaging technique used to evaluate the function of prosthetic cardiac valves. Prosthetic cardiac valves are used to replace damaged or diseased heart valves, and they can be mechanical or bioprosthetic. Echocardiography is an important tool to evaluate the function of prosthetic cardiac valves and detect any potential problems.

There are two types of echocardiography that can be used to evaluate prosthetic cardiac valves: transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). TTE is a non-invasive procedure that uses ultrasound waves to create images of the heart from outside the body. TEE is a more invasive procedure that involves inserting a probe through the mouth and into the esophagus to obtain images of the heart from a closer perspective.

Tags : Echocardiographic Evaluation of Prosthetic Cardiac Valves, prosthetic cardiac valves, non-invasive imaging technique, transthoracic echocardiography, transesophageal echocardiography, cardiology, cardiology PowerPoint presentation

Published on : Mar 19, 2023 | Views : 1074 | Downloads : 1

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Slide 1-

Thanks ………… Echocardiographic Evaluation Of Prosthetic Cardiac Valves Dr Gaurav Kumar Chaudhary MD,DM( Cardiology) Assistant Professor Department of Cardiology King George Medical University ,Lucknow a Cardiology Department K.G.M.U
Slide 2-

Outline When we should asses Prosthetic valve function ? What are parameters that need to be assessed? How should we assess? ECHO images of assessment of patients with prosthetic valve Learning Points in Presentation Cardiology Department K.G.M.U
Slide 3-

An echocardiographic examination performed 6 weeks to 3 months after valve implantation It allows for an assessment of the effects and results of surgery Serves as a baseline for comparison should complications or deterioration occur later Timing of assessment of prosthetic valve Cardiology Department K.G.M.U 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Slide 4-

Asymptomatic uncomplicated patient is usually seen at 1–year intervals for a cardiac history and physical examination No further echocardiographic testing is required after the initial postoperative evaluation in patients with mechanical valves Who are stable Who have no symptoms No clinical evidence of prosthetic valve or ventricular dysfunction or dysfunction of other heart valves. Cardiology Department K.G.M.U Timing of assessment of prosthetic valve 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
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Cardiology Department K.G.M.U Timing of assessment of prosthetic valve 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Slide 6-

Motion of leaflets or occluder Presence of calcification on the leaflets Any abnormal densities on the various components of the prosthesis Valve sewing ring integrity and motion Cardiology Department K.G.M.U Imaging of valve Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009
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Contour of jet velocity signal Peak velocity and gradient Mean pressure gradient VTI of the jet DVI Pressure half time in MV and TV EOA Presence, location and severity of regurgitation Doppler Study of Prosthetic valve Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009 Cardiology Department K.G.M.U
Slide 8-

Case 1 27 yr female ,Post MVR (SJM ) 1 yr back Cardiology Department K.G.M.U Case 1
Slide 9-

Leaflet excursion normal Cardiology Department K.G.M.U
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OC,CC Sharp Cardiology Department K.G.M.U
Slide 11-

PG/MG= 3.5/2.2 mm Hg Cardiology Department K.G.M.U
Slide 12-

MVA =3.6 cm2 Cardiology Department K.G.M.U
Slide 13-

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009 Cardiology Department K.G.M.U
Slide 14-

Case 2 35 yr male Post DVR (MVR+AVR ) , SJM ,August 2014 Cardiology Department K.G.M.U Case 2
Slide 15-

Cardiology Department K.G.M.U Normal leaflet excursion ,posterior leaflet ?Calcification/Pannus
Slide 16-

Cardiology Department K.G.M.U Normal leaflet excursion with acoustic shadowing
Slide 17-

Fibrous pannus, is usually annular in location Pannus formation is more frequent on aortic than on mitral prostheses On mitral prosthetic valves, they most often occur on the atrial side of the prosthesis Typically presenting as a very dense immobile echo, pannus are typically seen in patients with Normal anticoagulation profile Subacute or chronic symptoms Pannus versus Thrombus Cardiology Department K.G.M.U
Slide 18-

Pannus versus Thrombus Cardiology Department K.G.M.U
Slide 19-

Cardiology Department K.G.M.U Pannus formation
Slide 20-

Cardiology Department K.G.M.U
Slide 21-

Cardiology Department K.G.M.U Thrombus on prosthetic valve
Slide 22-

Mild paravalvular leak Cardiology Department K.G.M.U
Slide 23-

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009 Cardiology Department K.G.M.U
Slide 24-

Cardiology Department K.G.M.U
Slide 25-

Cardiology Department K.G.M.U
Slide 26-

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009 Cardiology Department K.G.M.U
Slide 27-

Velocity at prosthetic valve level 2m/s Velocity at LVOT level 1m/s DVI =1/2=.5
Slide 28-

DVI (Doppler velocity index) DVI is a dimensionless ratio of the proximal velocity in the LVO tract to that of flow velocity through the prosthesis: DVI = VLVO/VPrAV Normal prosthetic valve function Mean DVI, 0.39; range - 0.28-0.55 A DVI < 0.25 is highly suggestive of significant valve obstruction Cardiology Department K.G.M.U DVI (Doppler velocity index )
Slide 29-

Cardiology Department K.G.M.U Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009
Slide 30-

Case 3 30 yr female ,post MVR (SJM ) Cardiology Department K.G.M.U Case 3
Slide 31-

Leaflet excursion normal Cardiology Department K.G.M.U
Slide 32-

OC,CC Sharp Cardiology Department K.G.M.U
Slide 33-

Trivial paravalvular leakage Cardiology Department K.G.M.U
Slide 34-

TTE Can be deceptive sometimes !!!!! Cardiology Department K.G.M.U
Slide 35-

Cardiology Department K.G.M.U
Slide 36-

Cardiology Department K.G.M.U
Slide 37-

2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Cardiology Department K.G.M.U Prosthetic valve stenosis/regurgitation …..
Slide 38-

Case 4 35 yr male ,Post MVR (TTK 29 Chitra ) in oct 2008 Cardiology Department K.G.M.U Case 4
Slide 39-

Single Tilting disc excursion normal Cardiology Department K.G.M.U
Slide 40-

Cardiology Department K.G.M.U
Slide 41-

Cardiology Department K.G.M.U
Slide 42-

Cardiology Department K.G.M.U
Slide 43-

Cardiology Department K.G.M.U
Slide 44-

TTK chitra valve Tilting disc valve Metallic housing (cobalt based wrought alloy) Circular disc high molecular weight polyethylene Polyester suture ring Hemodynamically comparable to other mechanical valves Valve related complications are similar Cardiology Department K.G.M.U
Slide 45-

Case 5 65 yr male Post CABG (LIMA –LAD,SVG-RCA) + AVR ( 21 A –SJM ) in may 2014 Cardiology Department K.G.M.U Case 5
Slide 46-

Well preserved LVEF Cardiology Department K.G.M.U
Slide 47-

Trivial AR, No significant gradient across Prosthetic valve
Slide 48-

Patient-prosthesis mismatch (PPM) It is Nonstructural dysfunction, a composite category that includes any abnormality that results in stenosis or regurgitation of the operated valve that is not intrinsic to the valve itself, exclusive of thrombosis and infection This includes inappropriate sizing, which is called valve prosthesis–patient mismatch (VP-PM) When the effective prosthetic valve area, after insertion into the patient less than that of a normal valve Patients with aortic PHV have obstruction to left ventricular outflow (similar to aortic stenosis), and patients with mitral PHV have obstruction to left atrial emptying (similar to mitral stenosis) Cardiology Department K.G.M.U
Slide 49-

Cardiology Department K.G.M.U Patient-prosthesis mismatch (PPM)
Slide 50-

Cardiology Department K.G.M.U Bioprosthesis evalvation
Slide 51-

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE 2009 Cardiology Department K.G.M.U
Slide 52-

Thank you