What is the clinical evidence from this study?

Study design: Observational. Population: Suspected cardioembolic event or valve dysfunction in patients with a valve prosthesis (n=214). Intervention: Suspected cardioembolic event vs. Suspected valve dysfunction. Primary outcome: Prevalence of prosthetic valve strands (p=0.0001).

What does this research mean for the field?

Prosthetic valve strands detected by transesophageal echocardiography are significantly more prevalent in patients evaluated for suspected cardioembolic events compared to those evaluated for valve dysfunction, indicating they are a potential cardiac source of embolism. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to assess the frequency of prosthetic valve strands detected by transesophageal echocardiography and their association with cardioembolic events.

July 10, 2026Journal of the American College of CardiologyOpen Access

Detection of prosthetic valve strands by transesophageal echocardiography: Clinical significance in patients with suspected cardiac source of embolism

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Key result

Prosthetic valve strands are ~3.5 times more prevalent in suspected cardioembolic events versus valve dysfunction.

P=0.0001
n=214

Why the study?

Prosthetic mitral valve strands had uncertain clinical significance, reports of aortic prosthesis strands were lacking, and data linking strands to cardioembolic events were limited.

Population

214 transesophageal echocardiographic studies in patients with prosthetic valves

Comparison

Suspected cardioembolic event vs suspected valve dysfunction

Design

Single-center retrospective observational study

Authors

DODavid A. OrsinelliCardiac Imaging APAnthony C. PearsonUniversity of Chicago

Discussion

Member takes

Implication

Prosthetic valve strands may warrant TEE scrutiny in embolism suspects; observational data leaves open causality and management implications.

Key Points

This study aims to assess the frequency of prosthetic valve strands detected by transesophageal echocardiography and their association with cardioembolic events.
Conducted a 5-year review of transesophageal echocardiographic studies for valve dysfunction and suspected cardioembolic events.
Compared prevalence of strands between patients with suspected cardioembolic events and those with valve dysfunction.
Evaluated other potential cardiac embolic sources in cases without detectable strands.
Strands detected in 56 (26%) of 214 studies, with 53% prevalence in suspected cardioembolic event studies (34 of 64).
Significantly more strands found on mitral valves (32%) than on aortic valves (13%, p = 0.0004).
Strands more frequently found on mechanical valves (27%) compared to bioprosthetic valves (8%, p = 0.003).

Study Design

Type

Observational (n=214)

Multicenter

PICO

Population

214 transesophageal echocardiographic studies of patients with a valve prosthesis evaluated for a suspected cardioembolic event or valve dysfunction over a 5-year period.

Exposure / Comparator

Suspected cardioembolic event vs Suspected valve dysfunction

Primary Outcome

Prevalence of prosthetic valve strands, p=0.0001

Main Result

Absolute Event Rate: 53% vs 15%

p-value: p=0.0001

Cite This Study

Orsinelli et al. (1995) conducted an observational in Suspected cardioembolic event or valve dysfunction in patients with a valve prosthesis (n=214). Suspected cardioembolic event vs. Suspected valve dysfunction was evaluated on Prevalence of prosthetic valve strands (p=0.0001). Prosthetic valve strands were significantly more prevalent in patients evaluated for a suspected cardioembolic event compared to those evaluated for suspected valve dysfunction (53% vs 15%, p=0.0001).

synapsesocial.com/papers/6a5064a4330ff8da2846ea40 https://doi.org/10.1016/0735-1097(95)00375-4

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Implication

Prosthetic valve strands may warrant TEE scrutiny in embolism suspects; observational data leaves open causality and management implications.

Detection of prosthetic valve strands by transesophageal echocardiography: Clinical significance in patients with suspected cardiac source of embolism

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Detection of prosthetic valve strands by transesophageal echocardiography: Clinical significance in patients with suspected cardiac source of embolism

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Also Consider

Also Consider