Doppler echocardiographic evaluation of St. Jude Medical valves in the tricuspid position.
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Sixteen of 20 patients who underwent tricuspid valve replacement with a St. Jude Medical valve at our hospital were followed for three to 164 months. Doppler echocardiographic and cineradiographic examinations of the replacement device were performed in 13 patients. There were six males and seven females in the study, with a mean age of 41.9 years. A St. Jude Medical prosthesis had also been implanted in the mitral or mitral and aortic positions of eight of these thirteen patients. Ten patients had normally functioning valves in the tricuspid position and three were diagnosed as malfunctioning. The peak velocity in those patients with normally functioning tricuspid valves was 1.3 +/- 0.2 m/sec. The calculated peak and mean pressure gradients were 6.7 +/- 1.9 mmHg and 2.6 +/- 1.1 mmHg, respectively, and the mean pressure half-time was 120 +/- 22 msec. All normally functioning valves in the tricuspid position had peak velocities of less than 1.55 m/sec, and peak and mean pressure gradients of less than 9.6 mmHg and 5 mmHg, respectively, with the pressure half-time being less than 140 msec in all cases, except for one of the three Doppler studies performed in one patient. However, three Doppler studies performed in two patients with a malfunctioning tricuspid valve revealed peak velocities, peak and mean pressure gradients and pressure half-times which were above these values. After replacement of the malfunctioning valve, or thrombolysis, all of the Doppler-derived values returned to the range found in normally functioning valves.(ABSTRACT TRUNCATED AT 250 WORDS)