Article information
En niños con insuficiencia o estenosis valvular significativa, la intervención de la válvula, ya sea valvuloplastia o reemplazo valvular, suele ser inevitable. El seguimiento de estos pacientes puede ser complejo; los síntomas iniciales de disfunción valvular protésica son inespecíficos y en ocasiones es difícil diferenciar entre los efectos de la disfunción valvular, las patologías no cardíacas, la disfunción ventricular y la hipertensión pulmonar. Aunque el examen físico puede alertar al clínico acerca de alteraciones, se requieren otros métodos diagnósticos para evaluar la función de la prótesis. La ecocardiografía Doppler es el método de elección no invasivo para estudiar la función valvular y pese a que muchas de las mediciones y parámetros de normalidad y anormalidad son extrapolados de estudios en adultos, se han tratado de definir estándares en pacientes pediátricos. Este documento ofrece una revisión acerca de las técnicas usadas en el estudio de las válvulas protésicas con base en literatura científica, consensos internacionales y opiniones de expertos.
Palabras clave:
cardiología
prótesis valvular
ecocardiografía
In children with significant valvular insufficiency or stenosis, valve surgery, either valvuloplasty or valve replacement is usually inevitable. The monitoring of these patients can be complex, the initial symptoms of prosthetic valve dysfunction are nonspecific and sometimes difficult to differentiate between the effects of valvular dysfunction, non-cardiac pathologies, ventricular dysfunction and pulmonary hypertension. Although physical examination may alert the clinician about alterations, other diagnostic methods to assess the function of the prosthesis is required. Doppler echocardiography is the noninvasive method of choice to study valvular function and although many of the measurements and parameters of normality and abnormality are extrapolated from adult studies have been attempted to define standards in pediatric patients. This document provides an overview about the techniques used in the study of prosthetic valves based on scientific literature, international consensus and expert opinion.
Key words:
cardiology
valvular prosthesis
Echocardiography
Full text is only aviable in PDF
Bibliografía
[1.]
C. Van Doorn, R. Yates, V. Tsang, M. deLeval, M. Elliott.
Mitral valve replacement in children: mortality, morbidity and haemodynamic status up to medium term follow up.
Heart, 84 (2000), pp. 636-642
[2.]
B.K. Lam, V. Chan, P. Hendry, M. Ruel, R. Masters, P. Bedard, et al.
The impact of patient-prosthesis mismatch on late outcomes after mitral valve replacement.
J Thorac Cardiovasc Surg, 133 (2007), pp. 1464-1473
[3.]
T. Karamlou, K. Jang, W.G. Williams, C.A. Caldarone, G. Van Arsdell, J.G. Coles, et al.
Outcomes and associated risk factors for aortic valve replacement in 160 children: a competing-risks analysis.
Circulation, 112 (2005), pp. 3462-3469
[4.]
P. Pibarot, J.G. Dumesnil.
Prosthesis-patient mismatch: definition, clinical impact, and prevention.
Heart, 92 (2006), pp. 1022-1029
[5.]
C. Muneretto, G. Bisleri, A. Negri, J. Manfredi.
The concept of patient-prosthesis mismatch.
J Heart Valve Dis, 13 (2004), pp. S59-S62
[6.]
W.A. Zoghbi, J.B. Chambers, J.G. Dumesnil, E. Foster, J.S. Gottdiener, P.A. Grayburn, et al.
Recommendations for evaluation of prosthetic valves with echocardiography and doppler ultrasound: a report From the American Society of Echocardiography's Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography.
J Am Soc Echocardiogr, 22 (2009), pp. 975-1014
[7.]
L. Lopez, S.D. Colan, P.C. Frommelt, G.J. Ensing, K. Kendall, A.K. Younoszai, et al.
Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council.
J Am Soc Echocardiogr, 23 (2010), pp. 465-495
[8.]
H. Chubb, J.M. Simpson.
The use of Z-scores in paediatric cardiology.
Ann Pediatr Cardiol, 5 (2012), pp. 179-184
[9.]
M. Muratori, P. Montorsi, G. Teruzzi, F. Celeste, E. Doria, F. Alamanni, et al.
Feasibility and diagnostic accuracy of quantitative assessment of mechanical prostheses leaflet motion by transthoracic and transesophageal echocardiography in suspected prosthetic valve dysfunction.
Am J Cardiol, 97 (2006), pp. 94-100
[10.]
R.M. Saad, J. Barbetseas, L. Olmos, N. Rubio, W.A. Zoghbi.
Application of the continuity equation and valve resistance to the evaluation of St Jude Medical prosthetic aortic valve dysfunction.
Am J Cardiol, 80 (1997), pp. 1239-1242
[11.]
R.H. Marcus, R.S. Heinrich, J. Bednarz, S. Lupovitch, J. Abruzzo, R. Borok, et al.
Assessment of small-diameter aortic mechanical prostheses: physiological relevance of the Doppler gradient, utility of flow augmentation, and limitations of orifice area estimation.
Circulation, 98 (1998), pp. 866-872
[12.]
P. Pibarot, J.G. Dumesnil.
Hemodynamic and clinical impact of prosthesis patient mismatch in the aortic valve position and its prevention.
J Am Coll Cardiol, 36 (2000), pp. 1131-1141
[13.]
M.Y. Rashtian, D.M. Stevenson, D.T. Allen, A.P. Yoganathan, E.C. Harrison, W.A. Edmiston, et al.
Flow characteristics of four commonly used mechanical heart valves.
Am J Cardiol, 58 (1986), pp. 743-752
[14.]
D.L. Sprecher, R. Adamick, D. Adams, J. Kisslo.
In vitro color flow, pulsed and continuous wave Doppler ultrasound masking of flow by prosthetic valves.
J Am Coll Cardiol, 9 (1987), pp. 1306-1310
[15.]
K.C. Kocis, A.R. Snider, F.M. Lupinetti, E.L. Bove.
Doppler forward flow profiles of St Jude Medical prosthetic valves in pediatric patients.
Am J Cardiol, 74 (1994), pp. 77-79
[16.]
J.S. Sachweh, A.R. Tiete, E.G. Mühler, J. Groetzner, H. Gulbins, B.J. Messmer, et al.
Mechanical aortic and mitral valve replacement in infants and children.
Thorac Cardiovasc Surg, 55 (2007), pp. 156-162
[17.]
I.P. Panidis, J. Ross, G.S. Mintz.
Normal and abnormal prosthetic valve function as assessed by Doppler echocardiography.
J Am Coll Cardiol, 8 (1986), pp. 317-326
[18.]
S.A. Daneshvar, S.H. Rahimtoola.
Valve prosthesis-patient mismatch (VP-PM): a long-term perspective.
J Am Coll Cardiol, 60 (2012), pp. 1123-1135
[19.]
J.G. Dumesnil, P. Pibarot.
Prosthesis-patient mismatch and clinical outcomes: the evidence continues to accumulate.
J Thorac Cardiovasc Surg, 131 (2006), pp. 952-955
[20.]
C. Blais, J.G. Dumesnil, R. Baillot, S. Simard, D. Doyle, P. Pibarot.
Impact of valve prosthesis-patient mismatch on short-term mortality after aortic valve replacement.
Circulation, 108 (2003), pp. 983-988
[21.]
G. Tasca, F. Brunelli, M. Cirillo, M. DallaTomba, Z. Mhagna, G. Troise, et al.
Impact of valve prosthesis-patient mismatch on left ventricular mass regression following aortic valve replacement.
Ann Thorac Surg, 79 (2005), pp. 505-510
[22.]
E.H. Blackstone, D.M. Cosgrove, W.R. Jamieson, N.J. Birkmeyer, J.H. Lemmer Jr., D.C. Miller, et al.
Prosthesis size and long-term survival after aortic valve replacement.
J Thorac Cardiovasc Surg, 126 (2003), pp. 783-796
[23.]
C.M. Otto, A.S. Pearlman, K.A. Comess, R.P. Reamer, C.L. Janko, L.L. Huntsman.
Determination of the stenotic aortic valve area in adults using Doppler echocardiography.
J Am Coll Cardiol, 7 (1986), pp. 509-517
[24.]
H. Baumgartner, S.S. Khan, M. DeRobertis, L.S. Czer, G. Maurer.
Doppler assessment of prosthetic valve orifice area An in vitro study.
Circulation, 85 (1992), pp. 2275-2283
[25.]
L. Grigg, J. Fulop, L. Daniel, R. Weisel, H. Rakowski.
Doppler echocardiography assessment of prosthetic heart valves.
Echocardiography, 7 (1990), pp. 97-114
[26.]
R. Rosenhek, T. Binder, G. Maurer, H. Baumgartner.
Normal values for Doppler echocardiographic assessment of heart valve prostheses.
J Am Soc Echocardiogr, 16 (2003), pp. 1116-1127
[27.]
W.A. Zoghbi, K.L. Farmer, J.G. Soto, J.G. Nelson, M.A. Quinones.
Accurate noninvasive quantification of stenotic aortic valve area by Doppler echocardiography.
Circulation, 73 (1986), pp. 452-459
[28.]
N. Hanayama, G.T. Christakis, H.R. Mallidi, C.D. Joyner, S.E. Fremes, C.D. Morgan, et al.
Patient prosthesis mismatch is rare after aortic valve replacement: valve size may be irrelevant.
Ann Thorac Surg, 73 (2002), pp. 1822-1829
[29.]
J.N. Bitar, M.E. Lechin, G. Salazar, W.A. Zoghbi.
Doppler echocardiographic assessment with the continuity equation of St Jude Medical mechanical prostheses in the mitral valve position.
Am J Cardiol, 76 (1995), pp. 287-293
[30.]
J.G. Dumesnil, G.N. Honos, M. Lemieux, J. Beauchemin.
Validation and applications of mitral prosthetic valvular areas calculated by Doppler echocardiography.
Am J Cardiol, 65 (1990), pp. 1443-1448
[31.]
J.F. Malouf, M. Ballo, H.M. Connolly, D.O. Hodge, R.M. Herges, C.J. Mullany, et al.
Doppler echocardiography of 119 normal-functioning St Jude Medical mitral valve prostheses: a comprehensive assessment including time-velocity integral ratio and prosthesis performance index.
J Am Soc Echocardiogr, 18 (2005), pp. 252-256
[32.]
A. Vitarelli, Y. Conde, E. Cimino, T. Leone, I. D’Angeli, S. D’Orazio, et al.
Assessment of severity of mechanical prosthetic mitral regurgitation by transoesophageal echocardiography.
Heart, 90 (2004), pp. 539-544
[33.]
M. Masuda, H. Kado, H. Tatewaki, Y. Shiokawa, H. Yasui.
Late results after mitral valve replacement with bileaflet mechanical prosthesis in children: evaluation of prosthesis-patient mismatch.
Ann Thorac Surg, 77 (2004), pp. 913-917
[34.]
C. Alexiou, M. Galogavrou, Q. Chen, A. McDonald, A.P. Salmon, B.K. Keeton, et al.
Mitral valve replacement with mechanical prostheses in children: improved operative risk and survival.
Eur J Cardiothorac Surg, 20 (2001), pp. 105-113
[35.]
M.F. Bazeed, M.S. Moselhy, A.I. Rezk, M.A. Al-Murayeh.
Low radiation dose noncontrast cardiac CT: is it of value in the evaluation of mechanical aortic valve.
Acta Radiol, 53 (2012), pp. 389-393
[36.]
T.E. Cianciulli, J.A. Lax, M.A. Beck, F.E. Cerruti, G.E. Gigena, M.C. Saccheri, et al.
Cinefluoroscopic assessment of mechanical disc prostheses: its value as a complementary method to echocardiography.
J Heart Valve Dis, 14 (2005), pp. 664-673
Copyright © 2014. Sociedad Colombiana de Cardiología y Cirugía Cardiovascular