Role of echocardiography and phonocardiography in diagnosis of mitral paraprosthetic regurgitation with Starr-Edwards prostheses.

Twenty-three patients who were symptomatic after mitral valve replacement, and in whom mitral paraprosthetic regurgitation was a possible cause of deterioration, were investigated by cardiac catheterization, phonocardiography, and echocardiography. Severe paraprosthetic regurgitation was present in ii patients and slight regurgitation in 2 patients. Two patients had aortic regurgitation which was responsible for their symptoms and the remaining 9 patients had either poor left ventricular function, an obstructed mitral prosthesis, or an obstructed tricuspid prosthesis. The various groups could not be identified on clinical, radiological, or electrocardiographic features, but severe paraprosthetic regurgitation was associated with a reduced A2-OC interval