[Noninvasive assessment of an aortic bioprosthesis malfunction with Doppler echocardiography].

A 27-year-old patient with aortic stenosis received a Carpentier Edwards bioprosthesis and a reconstruction of the mitral valve, in 1978. With auscultation, M-mode and two-dimensional echocardiography, we diagnosed in 1985 a malfunction of the aortic prosthesis with restenosis, insufficiency and mitral insufficiency. A reliable qualitative and quantitative non-invasive assessment, however, was only possible with Doppler echocardiography. The velocity of blood flow over the aortic valve was measured with the continuous-wave Doppler technique; the aortic valve pressure gradient and the valve area were determined. The pulsed Doppler allowed a semi-quantitative evaluation of the severity of the aortic and mitral insufficiency. The intraoperative and pathological anatomical results confirmed the results from Doppler echocardiography: aortic valve prosthesis malfunction with restenosis and insufficiency and mild haemodynamically insignificant mitral valve insufficiency. The need for cardiac catheterization in patients with valvular heart disease and prosthesis is discussed.