“…(3) It is difficult to detect a valve malfunction using traditional Doppler echocardiographic parameters due to their flow dependence (transvalvular pressure gradients), pressure recovery phenomenon [18], and a wide variation among Doppler-derived parameters even for the same valve. For this reasons, Aoyagi et al [19] and Montorsi et al [17] recommended that Doppler echocardiography should be used with another technique (such fluoroscopy or cineradiography).…”