Echocardiography After Surgery to Replace a Heart Valve

When you need it—and when you don’t

If you have surgery to replace a damaged heart valve, you may have a test called an echocardiogram or “echo.” It uses sound waves (ultrasound) to make images of the heart and valves.

This test can show if the new valve is working well. But sometimes the test is done very soon after surgery, while you are still in the hospital. Usually, that’s not useful. Here’s why:

An echo test isn’t always helpful right after valve replacement.

There are two kinds of surgery for a damaged heart valve—repairing the valve or replacing it with an artificial valve.

If you have a valve repair, the echo test can be used to find problems before you leave the hospital. You may need more surgery while you are still in the hospital.

But valve replacement is less complex than valve repair. If you have a replacement, an echo test is less likely to be helpful. It is less likely to find a problem that needs fixing. And if you do get the test, it will be more accurate several weeks after you leave the hospital. It is better if you have time to heal after your surgery.

An echo test can lead to other tests.

A standard echo test is painless and safe. But if the test images are not clear enough, your doctor might order another test to take more pictures of your heart. This test is a transesophageal echo-cardiogram (TEE).

In a TEE, a flexible tube is put down your throat and into your esophagus. You cannot eat or drink for eight hours before the TEE, and your throat may be sore for a few hours after. In rare cases the tube can injure the throat. You could also have problems with the medicine you take to relax, such as nausea and trouble breathing.

It makes little sense to risk having the second test when you don’t even need the first one at that time.

An echo test can cost a lot.

A standard echo can cost $1,000 to $2,000, and a TEE can cost $2,000 or more, according to CostHelper.com. Even with insurance, you may have to pay up to half the cost.

When should you have an echocardiogram after a valve replacement?

Your surgeon may order the test while you are still in the hospital after your surgery if:

  • You didn’t have a TEE during your surgery to check your new valve.
  • You have symptoms such as fever, chest pain, breathing problems, or fainting.

Or your doctor may order the test:

  • At a follow-up visit after you leave the hospital
  • At any time if you develop symptoms or a new heart murmur (a noise the doctor can hear during a physical exam)

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2013 Consumer Reports. Developed in cooperation with the Society of Thoracic Surgeons. To learn more about the sources used in this report and terms and conditions of use, visit ConsumerHealthChoices.org/about-us/.

07/2013