Serial echocardiographic and color flow Doppler studies were performed in 38 mitral and aortic bioprosthetic valves. In the ensuing three to four months of follow-up, 7 patients developed clinical, angiographic evidence of severe valve regurgitation due to structural valve degeneration. Analysis of ultrasound studies revealed that increased thickness of the cusp by echocardiography and presence of mild to moderate color flow Doppler regurgitation preceded clinical regurgi tation in 5 and 4 bioprostheses respectively.
In conclusion, echo and cardiac Doppler features of thickened and/or regur gitant valves are markers for degenerating bioprostheses and these features usually precede clinical dysfunction.
