Document Detail

High-intensity transient signals due to prosthetic valve obstruction: diagnostic and therapeutic implications.
MedLine Citation:
PMID:  15111152     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: High-intensity transient signals (HITS) can be detected by transcranial Doppler ultrasonography (TCD) in patients carrying a mechanical prosthetic valve. The HITS counts and a frequency analysis were evaluated in patients with prosthetic valve obstruction in the aortic position. METHODS: Simultaneous echocardiographic, cineradiographic, and TCD evaluations for a St. Jude Medical valve were performed in 108 patients. All patients were asymptomatic and had no significant stenosis of the carotid artery. The HITS were identified according to criteria established by consensus of the International Cerebral Hemodynamics Symposium. RESULTS: The HITS counts in 69 patients with normal prosthetic valve function were 2.2 +/- 4.4, and the counts in 39 patients with prosthetic valve obstruction (group D) were 8.3 +/- 10.8. This difference was significant (p = 0.0002). In 2 patients of group D who had a greater rate of less than 400 Hz HITS, which were produced by solid microemboli, thrombolysis resulted in a mitigation of restricted leaflet movement equal to or greater than 10(o). The total number of HITS decreased and the rate of less than 400 Hz HITS also markedly decreased after thrombolysis in these 2 patients. On the other hand, 4 patients who obtained no improvement of leaflet movement by thrombolysis had lower rates of less than 400 Hz HITS than did the 2 patients. CONCLUSIONS: These results suggest that measurement of HITS counts is useful for detection of prosthetic valve obstruction, and that a frequency analysis of HITS may be valuable to clarify the cause of the obstructed prosthetic valves.
Ryoichi Hiratsuka; Shuji Fukunaga; Eiki Tayama; Kazuyoshi Takagi; Koichi Arinaga; Takahiro Shojima; Hideki Teshima; Shigeaki Aoyagi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  77     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-04-27     Completed Date:  2004-06-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1615-21     Citation Subset:  AIM; IM    
Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
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MeSH Terms
Aged, 80 and over
Aortic Valve
Heart Valve Prosthesis / adverse effects*
Middle Aged
Postoperative Complications / diagnosis*,  drug therapy
Prosthesis Design
Prosthesis Failure
Thrombolytic Therapy
Ultrasonography, Doppler, Transcranial*

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