Echocardiographic Studies of Stented Fascia Lata Grafts in the Mitral Position

Nineteen patients with stented fascia lata grafts in the mitral position were studied by the reflected ultrasound technique. Eleven of these had competent grafts, two had minimal regurgitation and six had severe graft incompetence as judged by ventriculography and during surgery. The diastolic closure rate (E-F speed) of the cusps revealed significant correlation with the effective graft area derived by calculations from cardiac catheterization data ( P < 0.01), and indicated only mild to moderate stenosis. The exhibited cusp mobility revealed an amplitude which was comparable with and similar to that measured in cusps from freshly prepared fascia lata valves. The demonstrated cusp mobility and E-F speed did not show a statistically significant difference between competent and incompetent grafts ( P > 0.7 and P > 0.4 respectively). Further evidence is presented supporting the role played by the mitral annulus mobility in the production of echocardiographic diastolic movement of the leaflet.