The document evaluates prosthetic valves using 2D echocardiography, Doppler techniques, and transesophageal echocardiography (TEE) to assess regurgitation, obstruction, and valve degeneration. It discusses the pressure half-time (PHT) as an important indicator of stenosis severity and provides insight into Doppler assessments, including flow velocities and pressure gradients. Clinical parameters for mitral and aortic valves are also outlined, highlighting the complexities and considerations in evaluating prosthetic valve function.

1. EVALUTION OF PROSTHETIC
VALVES

2. APPROACH
 2D
 DOPPLER AND COLOR FLOW
 REGURGITATION
 OBSTRUCTION
 TEE

3. 2D
 DEHISENCE
 VEGETATION
 THROMBUS/PANNUS
 DEGNERATION OF TISSUE
DIFFICULTIES:
ECHO REVERBERATIONS

4. TYPES OF PROSTHETIC VALVES

5. 2D GOALS

6. M MODE

7. DOPPLER GOALS

8. ABNORMAL STRUCTURES

9. PRIMARY GOAL OF DOPPLER

10. DOPPLER ASSESMENT

11. DOPPLER
 Flow velocity across prosthetic valve
 Pressure gradient using bernolius eqaution 4V2
 Continuity eqa: to find EOA
 PHT
 Prosthetic has mild gradient compared with native
valve( location,type,size, various degree)
 Baseline echo after post operative to followup echo
for reference

12. High velocity and PHT
 Regurgitation and obstruction has high velocity
 PHT is prolonged for Obstruction.
 Where pht normal in regurgitation in mitral and
tricuspid prosthetic, forward flow is decreased.

13. PHT
 Pressure half-time (PHT) is defined as the time
required for the pressure gradient to decrease to half
of its maximal value, and is an index of stenosis
severity.

15. Uses of PHT
MITRAL PHT
 OBSTRUCTION : INCREASE
 REGURGITATION: NORMAL OR
DECREASE

16. LVOT VELOCITY
AORTIC LVOT VELOCITY
 OBSTRUCTION DECREASE forward flow decrease
 REGURGITATION INCREASE Forward flow increase

17. OBSTRUCTION
WHAT TO SEE
 VALVE SIZE
 TYPE OF VALVE
 LOCATION OF VALVE
 ANTICOGULANT TREATMENT
 HOW:
MOTION OF (valve,Ball, Disc) IS OBSTRUCTED

18. EOA

19. DVI

20. PPM

21. MANY REASONS FOR HIGH VELOCITY

22. PHSIOLOGY REGURGITATION

23. VALVE TYPE

24. PATHOLOGY REGURGITATION

25. REGURGITATION
 VALVULAR
Within th sewing ring
PARA VALVLAR
 Eccentric or large jet
 Marked variance
 Jet around the swing ring

30. CLINICAL UTILITY

31. PARAMETERS FOR MITRAL

32. PARAMETERS FOR AORTIC

34. CONTRAST

35. STRANDS

36. SUTURES

37. USE OF TEE

38. TEE USES

39. LIMITATION TEE

40. TAVI

41. INTRA OPERATIVE TEE USES