ECHO-PHONOCARDIOGRAPHIC CHARACTERISTICS OF THE NORMALLY FUNCTIONING COOLEY-CUTTER MITRAL VALVE PROSTHESIS.

Echocardiographic and phonocardiographic records of 19 patients with a normally functioning Cooley-Cutter mitral valve were analyzed in order to provide quantitative baseline values for this prosthesis. The average duration between the second heart sound and peak opening of the valve (A(2)-OC interval) was 83 +/- 4 (standard error of the mean) msec. The Q-CC interval (from the electrocardiographic Q wave to closure of the valve) was 71 +/- 2 msec. Mean opening and closing velocities of the disc were similar (396 +/- 11 mm/sec and 393 +/- 12 mm/sec, respectively). Amplitude of disc excursion ranged from 6 to 9 mm, but this measurement was not possible in all patients due to the presence of spurious echoes. Early onset of prosthetic valve closure was a relatively common finding in patients with atrial fibrillation or with various forms of atrioventricular block, and frequently resulted in a variety of phonocardiographic alterations. Except for the A(2)-OC interval and amplitude of disc excursion, there was no significant correlation between valve size and echo-phonocardiographic measurements. Results of this study are compared with values previously reported for other types of caged disc valves, and the usefulness and limitations of echo-phonocardiographic assessment of prosthetic valve function are briefly discussed.