Why the study?
Does pulsed Doppler ultrasound accurately detect prosthetic mitral valve regurgitation compared to left ventriculography?
Does pulsed Doppler ultrasound accurately detect prosthetic mitral valve regurgitation compared to left ventriculography?
Pulsed Doppler ultrasound has poor sensitivity (20%) for detecting prosthetic mitral valve regurgitation compared to left ventriculography, meaning negative results should be interpreted with caution.
Negative pulsed Doppler results should not exclude prosthetic mitral regurgitation; leaves open the need for validated noninvasive alternatives.
Prosthetic mitral valve regurgitation was evaluated by both pulsed Doppler ultrasound and left ventriculography. Pulsed Doppler ultrasound was found to have only a 20% sensitivity in detecting prosthetic mitral valve regurgitation documented by left ventriculography. Possible reasons for this poor sensitivity include 1) an eccentric jet not identified by the small pulsed Doppler sample volume; 2) prosthesis interference with the Doppler signal in the apical four chamber view; and 3) the large angle of incidence between the pulsed Doppler signal and the regurgitant jet. Mitral insufficiency, especially when not severe, may be missed by this technique. Care must be taken in interpreting negative results from a pulsed Doppler ultrasound evaluation of a prosthetic mitral valve.
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Azuma et al. (1988) studied this question.
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