The purpose of this study was to provide comprehensive Doppler echocardiographic assessment of the function of the normal Starr-Edwards mitral valve prosthesis using all the Doppler hemodynamic variables described to date, including the mitral valve prosthesis time-velocity integral (TVI)/left ventricular outflow tract TVI ratio and the prosthesis performance index. All patients had a peak early mitral diastolic velocity of no more than 2 m/s or a pressure half-time that was less than 130 milliseconds. All but one patient had either a peak early mitral diastolic velocity of no more than 2 m/s or a mitral valve prosthesis TVI/left ventricular outflow tract TVI ratio of less than 2.2, regardless of prosthesis size or left ventricular systolic function. There was a trend of decreasing prosthesis performance index with increasing prosthesis valve size that was not statistically significant, however.