Prosthetic valve quick checks
A practical checklist of common Doppler parameters and red flags.
Prosthetic aortic valve – common parameters
- Peak velocity and mean gradient (compare to valve type/size norms when available).
- Dimensionless velocity index (DVI) = LVOT VTI / AV VTI (low values can suggest obstruction).
- Acceleration time (AT) and AT/ET ratio (prolonged AT can suggest obstruction).
- Effective orifice area (EOA) and indexed EOA (EOAi) when feasible.
- Look for regurgitation: central vs paravalvular; quantify when possible.
Prosthetic Doppler norms vary a lot by valve model/size. When in doubt, compare to manufacturer tables or your lab database.
Prosthetic mitral valve – common parameters
- Mean gradient (flow-dependent; consider HR and stroke volume).
- Pressure half-time can be misleading; use with caution.
- DVI (MV) can be used in some workflows (inflow vs LVOT), depending on lab practice.
- Assess for obstruction (restricted leaflet motion, elevated gradients, prolonged deceleration).
- Assess for regurgitation (central vs paravalvular) and pulmonary pressures.
Red flags that often deserve a second look
- New rise in gradient versus baseline study.
- New symptoms or hemolysis with paravalvular leak.
- High gradients with small indexed EOA suggesting patient–prosthesis mismatch (PPM).
- Discordant parameters (e.g., high gradient but normal DVI) → re-check measurements/flow state.
Want prosthetic calculators added?
Tell me what valves you see most (SAVR/TAVR models, MV prostheses) and I can add:
- Prosthetic AV DVI + AT/ET calculator
- EOA/EOAi calculators
- A “compare-to-baseline” helper to flag significant changes