Paravalvular mitral valve leakage presenting as congestive heart failure, missed by TTE but diagnosed by TEE: a case report

Table 1 Accepted mean pressure gradients across aortic and mitral prosthetic valves.

Valve type	Aortic		Mitral
	V max (m/s)	Mean Gradient (MG) (mmHg)	V max (m/s)	Mean Gradient(MG) (mmHg)	Causes of increase MG
Mechanical
Bileaflet (St. Jude)	2.5	12	1.6 +/- 0.3	4 +/- 1	Hyperdynamic Ventricle, Paravalvular leak, Suture déhiscence/abscess
Tilting disk	2.6 +/- 0.4	14 +/- 5	1.6 +/- 0.3	3 +/- 2
Ball cage	3.1 +/- 0.5	24 +/- 4	1.9 +/- 0.5	5 +/- 2
Tissue valves
Stented	2.6 +/- 0.4	13 +/- 6	1.8 +/- 0.2	6 +/- 2	Valve regurgitation, endocarditis, thrombosis
Non stented	2.2 +/- 0.4	3 (2–20)	1.5 +/- 0.2	4 +/- 2
AO homograft	1.8 +/- 0.4	7 +/- 3

The V_max and mean gradients across the aortic and mitral valves mentioned in the table are the normal pressures gradients expected in a size 23 mm prosthetic valve.[14]