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iamp;#39;m looking forward to spending a few moments to share with you some of my thoughts on the evaluation of prosthetic mitral valves i have no relevant financial relationships with which to disclose so we begin with a 55 year old woman sheamp;#39;s had three previous mitral valve replacements the most recent was in 1999 where she had a carbomedics valve placed she is now nyha functionally class 2 and has increasing right ventricular systolic pressures hereamp;#39;s the initial echocardiogram peristeral long axis view where you can see the chamber dimensions here the ejection fraction was reported at 53 percent with an estimated right ventricular systolic pressure of 58 millimeters of mercury here from an apical transducer position left ventricle left atrium color doppler here is a spectral doppler profile continuous wave through the mitral prosthesis and what we can appreciate is the peaky wave velocity is 2.4 meters per second the mean gradient is calculated at nine millimeters
