Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 1;6(1):G9-G15.
doi: 10.1530/ERP-18-0079.

Indications for echocardiography of replacement heart valves: a joint statement from the British Heart Valve Society and British Society of Echocardiography

John B Chambers  1 , Madalina Garbi  2 , Norman Briffa  3 , Vishal Sharma  4 , Richard P Steeds  5
Affiliations

Indications for echocardiography of replacement heart valves: a joint statement from the British Heart Valve Society and British Society of Echocardiography

John B Chambers et al. Echo Res Pract. .

Abstract

Echocardiography plays a vital role in the follow-up of patients with replacement heart valves. However, there is considerable variation in international guidelines regarding the recommended time points after implantation at which routine echocardiography should be performed. The purpose of routine echocardiography is to detect early structural valve deterioration in biological valves to improve the timing of redo interventions. However, the risk of valve deterioration depends on many valve-related factors (valve design and patient prosthesis mismatch) and patient-related factors (age, diabetes, systemic hypertension, renal dysfunction and smoking). In this statement, the British Heart Valve Society and the British Society of Echocardiography suggest practical guidance. A plan should be made soon after implantation, but this may need to be modified for individual patients and as circumstances change. It is important that patients are managed in a multidisciplinary valve clinic.

Keywords: echocardiography; structural valve deterioration; valve clinic; valve replacement.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Main types of surgical and transcatheter bioprosthetic heart valve. Reproduced from Journal of the American College of Cardiology, vol 69, Puri R, Auffret V & Rodés-Cabau J, Bioprosthetic valve thrombosis, pages 2193–2211, Copyright (2017), with permission from Elsevier (9).
Figure 2
Figure 2
Graph of structural valve deterioration in biological valves at 15–20 years according to the age at implantation. Constructed with data from multiple studies. Reproduced from Journal of the American College of Cardiology, vol 55, Rahimtoola SH, Choice of prosthetic heart valve in adults: an update., pages 2413–2426, Copyright (2010), with permission from Elsevier (16).
Figure 3
Figure 3
Recommendations for echocardiographic follow-up of normally functioning prosthetic valves post-implantation. TVR, tricuspid valve replacement. *High-risk features include age <60 years, patient–prosthesis mismatch, renal failure, type 2 diabetes.
See this image and copyright information in PMC

References

    1. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Mun.oz DR, et al 2017. ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal 2017. 38 2739–2791. (10.1093/eurheartj/ehx391) - DOI - PubMed
    1. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA, O’Gara PT, Ruiz CE, Skubas NJ, Sorajje P, et al 2014. AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Journal of the American College of Cardiology 2014. 63 e57–e185. (10.1016/j.jacc.2014.02.536) - DOI - PubMed
    1. Chambers JB, Garbi M, Nieman K, Myerson S, Pierard LA, Habib G, Zamorano JL, Edvardsen T, Lancellotti P, et al. Appropriateness criteria for the use of cardiovascular imaging in heart valve disease in adults: a European Association of Cardiovascular Imaging report of literature review and current practice. European Heart Journal Cardiovascular Imaging 2017. 18 489–498. (10.1093/ehjci/jew309) - DOI - PubMed
    1. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, Borger MA, Carrel TP, De Bonis M, Evangelista A, et al Guidelines on the management of valvular heart disease (version 2012). European Heart Journal 2012. 33 2451–2496. (10.1093/eurheartj/ehs109) - DOI - PubMed
    1. Zoghbi WA, Chambers JB, Dumesnil JG, Foster E, Gottdiener JS, Grayburn PA, Khandheria BK, Levine RA, Marx GR, Miller FA, et al Recommendations for evaluation of prosthetic valves with echocardiography and Doppler ultrasound: a report From the American Society of Echocardiography’s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. Journal of the American Society of Echocardiography 2009. 22 975–1014; quiz 1082. (10.1016/j.echo.2009.07.013) - DOI - PubMed

LinkOut - more resources