A Study of Prosthetic Heart Valve Sounds

In this paper a new mechanism is proposed for the generation of phonocardiogram (PCG) sounds from implanted mechanical prosthetic heart valves. The structures in the chest, the heart, its partitions, and major vessels, constitute a frequency selective system excited by the rapidly decelerating valve occluder. It is shown that the source, the rapidly decelerating valve, has a wide and flat power spectrum and hence is an impulsive excitation that couples energy to the resonance modes specified by the structures in the chest. Consequently, the PCG signal is composed of decaying sinusoids. The parameters of the decaying sinusoids are estimated, and it is observed that the power spectra of the PCG signals have two dominant peaks in the frequency band of 200-500 Hz. The energy coupled to these two modes depends on the state of the valve. With thrombus the decelerating occluder slows down and becomes a broader pulse concentrating the energy to the lower resonance mode. This is verified by experiments on 30 patients during postoperative time course. However, no significant change in the resonance frequencies are observed which is an evidence for their anatomical and not valvular dependence.