Abstract
Until January 1994, we observed 15 patients with a malfunctioning SJM valve. Normal range of leaflet mobility of a SJM valve by cineradiography and transvalvular hemodynamics by Doppler echocardiography were evaluatedin patients with a normally functioning SJM valve, and the results were compared with those obtained from the patients with a malfunctioning SJM valve. Opening and closing angles measuredby cineradiographyin 10 patients with an obstructed valve were strikingly abnormal, and clearly outside the normal range. Increases of transvalvular peak velocity and pressure gradients were recordedin 7 of 10 patients who underwent Doppler studies. In the other 5, Doppler color flow mapping showed abnormal transvalvular or parapros- thetic blood flow. We believe that cineradiography and Doppler echocardiography are the optimal methods for the diagnosis of malfunction of a SJM valve.