Which finding on echocardiography indicates prosthetic valve dysfunction?

Which finding on echocardiography indicates prosthetic valve dysfunction?

• A. Abnormal gradients across the prosthesis on CW Doppler.
• B. Decreased gradients across the prosthesis.
• C. Absence of regurgitation.
• D. Stable prosthetic function over time.

Answer: (A)

Abnormal gradients across the prosthetic valve on continuous-wave Doppler indicate dysfunction because elevated flow velocity and gradients reflect increased resistance to opening, i.e., stenosis or obstruction of the valve. This directly shows the prosthesis is hindering forward flow beyond what’s expected for its size and type. Decreased gradients can occur with low-flow states and do not signal dysfunction, absence of regurgitation isn’t a reliable absence of problems, and stability over time suggests normal function rather than dysfunction.

Abnormal gradients across the prosthetic valve on continuous-wave Doppler indicate dysfunction because elevated flow velocity and gradients reflect increased resistance to opening, i.e., stenosis or obstruction of the valve. This directly shows the prosthesis is hindering forward flow beyond what’s expected for its size and type. Decreased gradients can occur with low-flow states and do not signal dysfunction, absence of regurgitation isn’t a reliable absence of problems, and stability over time suggests normal function rather than dysfunction.