Experience with a Hand-held Device (Thrombocheck©) for the Detection
of Bileaflet Prosthetic Valve Malfunction
The Dan Sheingarten Echocardiography Unit and Valvular
Clinic, Department of Cardiology, Rabin Medical Center, Beilinson Campus,
Petah Tiqva, affiliated with the Sackler Faculty of Medicine, Tel-Aviv
University, Tel Aviv, Israel
Background and aim of the study: Early recognition
of subclinical prosthetic valve malfunction may promote early treatment
and avoidance of serious complications. Echocardiography cannot be applied
on a daily basis; thus, a hand-held device (Thrombocheck©) which
is capable of detecting subtle changes in the acoustic sounds of prosthetic
valve has been developed for the routine home monitoring of heart valve
function. Herein is reported the authors’ initial clinical experience
with this device.
Methods: Seventy-one consecutive patients with one or
more bileaflet prosthetic mechanical valves at any position were
assessed both by transthoracic echocardiography (TTE) and by Thrombocheck.
These patients attended the authors’ clinic for either routine
echocardiography (n = 62) or for the detection of prosthetic valve
malfunction (n = 9). Cinefluoroscopy and transesophageal echocardiography
were used selectively to confirm prosthetic valve malfunction.
The Thrombocheck was held for 1 min in the subxiphoid
position perpendicular to the patient, and indicated either normal function
(OK), abnormal function (Warning) or ‘no signal’.
Results: The study patients had in total 82 bileaflet
valves (47 mitral, 31 aortic, four tricuspid). Eight patients (11.3%)
had a ‘no signal’ indication. Of the remaining 63 patients,
10 (15.9%) had a ‘warning’ alarm (eight patients had
current abnormal leaflet motion, one patient had a recent history
of abnormal leaflet motion, and one had no evidence of prosthetic
valve malfunction). The sensitivity and specificity for detecting
abnormal prosthetic valve malfunction were 90% and 98%, respectively.
Conclusion: The Thrombocheck had an excellent sensitivity
and specificity for the detection of prosthetic valve malfunction
in a cohort of patients with bileaflet mechanical prosthetic heart
The Journal of Heart Valve Disease 2005;14:476-480