Prosthetic mechanical valves are the elective choice in mitral valve (MV) replacement, because of their reliability and easiness of implantation. However, these prostheses can suffer from complications, the major one being prosthetic mitral valve thrombosis (PMVT). In these cases, transthoracic doppler echocardiogram (TDE) is the standard diagnostic workup for diagnosis of valve malfunction. The American Society of Echocardiography (ASE) indicates the possible TDE-derived indexes, which can help in identifying insurgence of MV replacement complications. Unfortunately, in some cases, it is not possible to detect PMVT based on these criteria. In these cases, we speak of Doppler silent thrombosis and only more accurate and invasive analyses, such as fluoroscopy, allow for a correct diagnosis. In this work, computational fluid dynamic models were implemented to simulate valve fluid dynamics in different clinical scenarios in order to improve the reliability of PMVT diagnosis based on TDE.
Meskin M, Dimasi A, Votta E, Jaworek M, Fusini L, Muratori M, Montorsi P, Zappa E, Epifani I, Pepi M, Redaelli A. A Novel Multiparametric Score for the Detection and Grading of Prosthetic Mitral Valve Obstruction in Cases With Different Disc Motion Abnormalities. Ultrasound Med Biol 9 May 4. pii: S0301-5629(19)30126-7. doi: 10.1016/j.ultrasmedbio.2019.03.011