Key result
Further investigation of an asymptomatic high Doppler gradient across a mechanical aortic valve identified a thrombus, leading to reoperation.
Why the study?
Should asymptomatic patients with high Doppler gradients across mechanical valves undergo reoperation based on echocardiographic findings?
Case Report (n=1)
Should asymptomatic patients with high Doppler gradients across mechanical valves undergo reoperation based on echocardiographic findings?
Highlights the clinical dilemma of whether to intervene based on abnormal echocardiographic findings in an asymptomatic patient with a mechanical valve.
It is not unusual to find a Doppler derived peak gradient of 40 mm Hg across a Bjork-Shiley valve in the aortic position. However, in the case reported below1 further investigation led to the identification of thrombus, and the patient underwent reoperation despite being asymptomatic. Should this case affect our management of mechanical valves? Most centres perform routine postoperative echocardiography. This is useful to compare with future studies as a new paraprosthetic leak may be a sign of endocarditis, and a major change in forward …
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John B. Chambers (1999) conducted a case report in Mechanical valve thrombus (n=1). Reoperation based on echocardiographic findings was evaluated. Further investigation of an asymptomatic high Doppler gradient across a mechanical aortic valve identified a thrombus, leading to reoperation.
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