Intracavitary echoes in patients with mitral prosthetic valves

In the course of doing routine echocardiograms on patients with mitral prosthetic valves, we observed peculiar intracavitary echoes within the left ventricle. Of the 36 valves studied in 31 different patients, 14 echocardiograms demonstrated the abnormal intracavitary echoes and 22 did not. The presence of mitral insufficiency, atrial fibrillation, systemic emboli and warfarin sodium (Coumadin) therapy were roughly equal in the two groups. A higher percentage of abnormal intracavitary echoes occurred in patients with a hemoglobin less than 11 gm/100 ml, other prosthetic valves, cloth covered valves, low platelets, and functional class III–IV. Although this study does not clarify the origin of these abnormal echoes, it is possible that they originate from particulate matter such as tiny fibrin clots or fibers from the cloth covering of the valve.