Echocardiography Techniques I Exam 1 Practice

Prosthetic valve dysfunction shows up on echocardiography as evidence of obstruction or leakage related to the prosthesis. When the valve is obstructed or stenotic, the transvalvular gradients rise and the effective orifice area decreases, reflecting reduced flow through a narrowed opening. Doppler measurements, including the calculated effective orifice area, help quantify this and distinguish true stenosis from normal post-implant gradients that can occur with small or incorrectly sized valves.

Leakage around the valve, especially a significant paravalvular leak, is another key clue. This appears as a substantial jet surrounding the sewing ring on color Doppler, indicating dehiscence or imperfect seating of the prosthesis and resulting regurgitation. The presence of normal gradients with no PVL would argue against dysfunction, while markedly elevated gradients or a reduced EOA or a sizable paravalvular leak point to dysfunction. Enlarged LV volumes with preserved function alone does not define prosthetic valve dysfunction.