Paravalvular fistula in mitral valve implant. Intimation of malfunction of implant and quantification of regurgitant flow from effective area measurements.

Non-invasive ultrasound Doppler registrations and cardiac output determinations with a thermodilution catheter were performed in the presence of and after closure of a paravalvular mitral fistula in a 52-year-old patient with a 27 mm Björk-Shiley mitral valve. The data collected allowed the calculation of the regurgitant flow through the fistula. This study suggests that the method used can be of diagnostic value when mitral valve implant malfunction is suspected.