Raised Prosthetic Valve Gradients: What Should be the Approach?

Abstract

The introduction of valve replacement surgery has dramatically improved the outcome of patients with valvular heart disease. Echocardiography plays an important role to determine the outcome of the surgery and follow up of these patients with prosthetic heart valve. Flow across the prosthesis is determined by using Doppler echocardiography. Whenever there is a high gradient across a prosthetic valve, echocardiography becomes challenging, as there are many causes, which may give rise to high prosthetic valve gradient. Some of these causes are prosthesis-related which need urgent intervention and some are non-prosthesis-related. A careful systematic echocardiographic approach, using 2D, 3D, Doppler and transesophageal echocardiography is crucial to find out the exact cause of high gradient.

Keywords

• doppler echocardiography
• prosthetic valve
• raised gradients