Prosthetic Valves

BSE reference tables

Prosthetic aortic & mitral Doppler

Prosthetic aortic valve — normal vs stenotic Doppler parameters

Doppler assessment of a prosthetic aortic valve (EACVI/ASE). Compare with the patient's own baseline study where possible; size and type matter.

Prosthetic aortic valve — Doppler parameters
ParameterNormalPossible stenosisSignificant stenosis
Peak velocity (m/s)<33–4>4
Mean gradient (mmHg)<2020–35>35
Doppler velocity index (DVI)>0.300.29–0.25<0.25
EOA (cm²)>1.21.2–0.8<0.8
Acceleration time (ms)<8080–100>100
Jet contourTriangular, early-peakingIntermediateRounded, symmetrical

TextbookZoghbi et al. Recommendations for evaluation of prosthetic valves with echocardiography. ASE 2009.

Prosthetic mitral valve — normal vs stenotic Doppler parameters

Doppler assessment of a prosthetic mitral valve (EACVI/ASE). A high mean gradient with a long pressure half-time suggests obstruction; a high gradient with a short PHT suggests high flow (e.g. prosthetic regurgitation).

Prosthetic mitral valve — Doppler parameters
ParameterNormalPossible stenosisSignificant stenosis
Peak velocity (m/s)<1.91.9–2.5>2.5
Mean gradient (mmHg)<56–10>10
VTI prosthesis / VTI LVOT<2.22.2–2.5>2.5
EOA (cm²)>21–2<1
Pressure half-time (ms)<130130–200>200

TextbookZoghbi et al. Recommendations for evaluation of prosthetic valves with echocardiography. ASE 2009.

Revision flashcards

Prosthetic stenosis — flashcards

Prosthetic aortic valve — thresholds suggesting significant stenosis?

Prosthetic aortic valve — significant stenosis
Peak velocity>4m/s
Mean gradient>35mmHg
Doppler velocity index<0.25ratio
Effective orifice area<0.8cm²
Acceleration time>100ms

TextbookZoghbi et al. Recommendations for evaluation of prosthetic valves with echocardiography. ASE 2009.

Prosthetic mitral valve — thresholds suggesting significant stenosis?

Prosthetic mitral valve — significant stenosis
Mean gradient>10mmHg
Peak velocity>2.5m/s
Pressure half-time>200ms
Effective orifice area<1cm²

TextbookZoghbi et al. Recommendations for evaluation of prosthetic valves with echocardiography. ASE 2009.