In vitro ultrasonic imaging of flow through prosthetic heart valves.

Abstract

A rapid, inexpensive, portable technique has been developed for the qualitative and semiquantitative evaluation of in vitro flow characteristics through prosthetic heart valves. The technique combines a cardiac pulse duplicator and any diagnostic, linear sequential array, ultrasonic imaging system. The pulse duplicator has been modified to include an acoustically transparent aortic section which contains the prosthetic valve to be evaluated. The acoustically transparent section is fabricated from Rho-c rubber and enables direct flow-imaging for several centimeters on both sides of the prosthesis. Aerated tap water is used as a contrast medium. Forward and reverse flow, laminar flow complex eddy patterns, regurgitation, and jets are easily observed in real time over a wide field of view. Time-exposure photography of sequential images and subsequent off-line calculations enable point-by-point determinations of flow velocities. This work allowed preliminary evaluations of four cardiac valves: Bjork-Shiley, St. Jude, caged disk, and Starr-Edwards.