Echocardiographic Imaging of Cardiac Valves

Perioperative echocardiography (echo) has become the imaging modality of choice during cardiac valve surgery. It is a very useful tool not only for diagnosis of valvular disease but also for intraoperative monitoring of repair or replacement success. Being able to recognize potential issues with native and newly replaced or repaired valves is crucial for good surgical planning, especially in the immediate post-bypass period. By understanding how the ultrasound technology works as well as how to interpret echo image and measurements, one can help guide intraoperative decision-making and ensure successful patient outcomes. In this chapter, we will discuss the basic principles of ultrasound as well as the specific findings and assessments for each cardiac valve. We will discuss assessments of native valves, valve replacements, and valve repairs. Our chapter will cover 2D imaging, spectral Doppler, and color flow Doppler (CFD) in addition to newer 3D imaging, to demonstrate how this important tool can be used for assessing valve function before and after replacement or repair.