September 2009

Doppler interrogation with color and spectral modalities plays a central role in evaluating prosthetic valve function and related complications because of limitations of imaging alone, particularly in mechanical valves. In patients with suspected prosthetic valvular dysfunction, TEE is frequently needed for identification of the mechanism of obstruction or regurgitation, particularly in mechanical valves. In general, evaluation of prosthetic valve function is more challenging, on the basis of the variability of inherent mild obstruction observed with the wide range of prosthetic valve types and sizes. Thus, the cardiac history plays a major role in the echocardiographic evaluation by documenting the type and size of the inserted valve or conduit. Serial comparison with a baseline postoperative study is also essential in facilitating accurate assessment of valve function. More research is needed on normative values of various parameters of valvular function and their prognostic impact in the pediatric population.