Change in Echocardiogram Guidelines for Mechanical Valves

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tom in MO

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My aortic valve has been in for about 8 years. My cardio told me on Tuesday that the new standards of care for mechanical valves no longer recommends an echo every 5 years. Research has shown it's not needed. Echos are indicated if there is other clinical evidence of a problem or potential problem. So for those of us in the US, that's one less medical cost. It also speaks to the stability of the mechanical valve.

For biological valves, routine echos are still required to track the inevitable degradation of performance.
 
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Amy

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Jan 7, 2013
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I was just wondering about this yesterday - how often I’ll need an echo after next week’s AVR with a shiny new ticker.

Hooray!!!!!!
 

egar

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Apr 11, 2019
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I have a mechanical mitral valve. I had my last echo at Mayo Clinic in August 2020 (about 22 months post surgery). The results were great, all measures within normal ranges for someone without a mechanical valve. My cardiologist (also at Mayo), said that unless other issues come up, I did not need another echo for 10 years.
 

Amy

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That’s awesome. Thank you for sharing that.
 

pcannon

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Nov 28, 2020
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wow I guess I was so use to getting an echo every 6 months prior to getting my mitral valve I never thought I might not need to do that anymore. Thanks for sharing that information.
 

Amy

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Just found this paper, published 2 years ago (asterisks (*) mine) :

The purpose of routine echocardiography is to detect early SVD in order to observe the patient more frequently both clinically and echocardiographically and plan a redo procedure. However, SVD of modern mechanical valves is exceptionally rare (7) and happens suddenly with critical hemodynamic deterioration. Routine echocardiographic follow-up of mechanical valve prostheses in asymptomatic patients with no coexistent pathology is therefore not usually needed. *****However, patients with a mechanical mitral valve should have a routine echocardiogram at 5 years to assess for tricuspid regurgitation or worsening RV dysfunction if they did not undergo concomitant TV repair. ******
 

egar

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Apr 11, 2019
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wow I guess I was so use to getting an echo every 6 months prior to getting my mitral valve I never thought I might not need to do that anymore. Thanks for sharing that information.
I had been doing them annually for several years, both before and after surgery. I just figured it would always be an annual thing. I was surprised (and happy) at the cardiologist's recommendation of a 10 year interval.
 
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