Points
Ideally, a baseline postoperative transthoracic echocardiographic study should be performed at the first visit, 2 to 4 weeks after hospital discharge, when the chest wound has healed, ventricular function has improved, and anemia with its attendant hyperdynamic state has abated. However if the patient is being transferred and may not return, it may be best to perform the study before hospital discharge.
Routine follow-up clinical visits should be conducted annually after valve replacement, with earlier reevaluations and echocardiography if there is a change in clinical status.
Routine echocardiography after a first postoperative study is not indicated for normally functioning prostheses in the absence of associated pathology, other indications for echocardiography (e.g. follow-up of LV dysfunction), or clinical symptoms suggestive of valvular dysfunction or other cardiac pathology.
Patients with bioprosthetic valves may be considered for annual echocardiography after the first 5 years in the absence of a change in clinical status. In patients with mechanical heart valves, routine annual echocardiography is not indicated in the absence of a change in physical examination or clinical status.