Ultrasound detection of cerebral emboli in patients with prosthetic heart valves

Grosset, D.G. , Cowburn, P., Georgiadis, D., Dargie, H.J., Faichney, A. and Lees, K.R. (1994) Ultrasound detection of cerebral emboli in patients with prosthetic heart valves. Journal of Heart Valve Disease, 3(2), pp. 128-132. (PMID:7912147)

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Abstract

This study was undertaken in 64 patients, 50 with mechanical and 14 with porcine prosthetic valves, to evaluate the incidence of intracranial emboli and their distribution in the basal cerebral arteries. The patients were studied using transcranial Doppler (EME TC2-64B, Uberlingen, Germany), with a monitoring time of two minutes over each of the internal carotid arteries, middle and anterior cerebral arteries, vertebral arteries and the basilar artery. Sixty-three of the 64 patients were stabilized on warfarin at the time of the study. The incidence of emboli signals was significantly higher in patients with mechanical compared to porcine cardiac valves (88% versus 14%, p < 0.01). The number of emboli signals was significantly higher in the anterior compared with the posterior circulation, with a median of eight signals in the internal carotid arteries (95% confidence interval 5-15), 2.5 in the vertebral arteries (95% confidence interval 1-5.5)(p < 0.03). It was also significantly higher in those patients who had undergone double (aortic and mitral) as opposed to those who had undergone single aortic valve replacement: 18 versus two signals per minute (confidence intervals 5-30.5 versus 0.5-3.5) (p < 0.01). It is concluded that subclinical emboli signals are readily detectable using transcranial Doppler and are common in patients with prosthetic heart valves. Their number depends on both the type and the number of the prosthesis, while their distribution in the basal cerebral arteries is consistent with their cardiac source.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dargie, Professor Henry and Grosset, Dr Donald and Lees, Professor Kennedy
Authors: Grosset, D.G., Cowburn, P., Georgiadis, D., Dargie, H.J., Faichney, A., and Lees, K.R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Heart Valve Disease
ISSN:0966-8519
ISSN (Online):2053-2644

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