Doppler echocardiography in the assessment of the homograft aortic valve.

To determine the utility of Doppler echocardiography in the evaluation of the homograft valve in the aortic position, 27 patients with normally functioning valves (group 1) and 30 patients with suspected malfunctioning valves (group 2) were examined. Simultaneous cardiac catheterization and Doppler echocardiography were performed in 23 group 2 patients. Doppler and surgical findings were compared in 7 patients too ill for invasive studies. In group 1 patients, the maximal velocity (+/- standard deviation) was 1.8 +/- 0.37 m/s, the mean pressure gradient was 7.1 +/- 3.07 mm Hg and the mean aortic valve area was 2.2 +/- 0.79 cm2. The maximal velocity in group 2 patients with aortic regurgitation (AR) classified as moderate or greater was 2.5 +/- 0.55 m/s, compared with 1.8 +/- 0.44 m/s in patients with mild AR or less (p less than 0.01). In the quantitation of AR, pulsed-wave mapping and angiographic grades were identical in 18 patients and differed by 1 grade in 5. Seven patients too ill for catheterization had severe destruction of valve leaflets at cardiac surgery. In 6 patients, both Doppler grading methods suggested severe AR. In a seventh patient, who had an obstructed Starr-Edwards valve in the mitral position, AR was graded as mild by pulsed-wave mapping. Only 1 patient had homograft valve stenosis, with a withdrawal gradient at catheterization of 34 mm Hg and a Doppler maximal gradient of 36 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)