Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference
Autor: | Young Jin Kim, Suyon Chang, Byoung Wook Choi, Yoo Jin Hong, Geu Ru Hong, Sak Lee, Hye Jeong Lee, Jin Hur, Dong Jin Im, Young-Joo Suh, Byung Chul Chang, Chi Young Shim |
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Rok vydání: | 2015 |
Předmět: |
musculoskeletal diseases
Aortic valve Adult Male Reoperation medicine.medical_specialty Cardiac computed tomography medicine.medical_treatment Heart Valve Diseases Pannus 030204 cardiovascular system & hematology Multimodal Imaging Sensitivity and Specificity 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Valve replacement Aortic valve replacement Pannus Formation medicine Humans Prosthetic valve Heart Valve Prosthesis Implantation business.industry Mechanical Aortic Valve Middle Aged medicine.disease medicine.anatomical_structure Aortic Valve Heart Valve Prosthesis Female Radiology Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed human activities Echocardiography Transesophageal |
Zdroj: | International journal of cardiology. 214 |
ISSN: | 1874-1754 |
Popis: | Background The added value of cardiac computed tomography (CT) with transesophageal echocardiography (TEE) for evaluating mechanical aortic valve (AV) dysfunction has not yet been investigated. The purposes of this study were to investigate the added value of cardiac CT for evaluation of mechanical AVs and diagnoses of pannus compared to TEE, with surgical findings of redo-aortic valve replacement (AVR) used as a standard reference. Methods 25 patients who underwent redo-AVR due to mechanical AV dysfunction and cardiac CT before redo-AVR were included. The presence of pannus, encroachment ratio by pannus, and limitation of motion (LOM) were evaluated on CT. The diagnostic performance of pannus detection was compared using TEE, CT, and CT+TEE, with surgical findings as a standard reference. The added value of CT for diagnosing the cause of mechanical AV dysfunction was assessed compared to TTE+TEE. Results In two patients, CT analysis was not feasible due to severe metallic artifacts. On CT, pannus and LOM were found in 100% (23/23) and 60.9% (14/23). TEE identified pannus in 48.0% of patients (12/25). CT, TEE, and CT+TEE correctly identified pannus with sensitivity of 92.0%, 48.0%, and 92.0%, respectively (P=0.002 for CT vs. TEE). In 11 of 13 cases (84.6%) with inconclusive or negative TEE results for pannus, CT detected the pannus. Among 13 inconclusive cases of TTE+TEE for the cause of mechanical AV dysfunction, CT suggested 6 prosthetic valve obstruction (PVO) by pannus, 4 low-flow low-gradient PVO, and one LOM without significant PVO. Conclusions Cardiac CT showed added diagnostic value with TEE in the detection of pannus as the cause of mechanical AV dysfunction. |
Databáze: | OpenAIRE |
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