Highlights
- •Cardiac computed tomography has a complementary role to echocardiography in patients with suspected prosthetic heart valve dysfunction.
- •Cardiac computed tomography allows better detection of pannus and pseudoaneurysm
- •Echocardiography is superior in detection of prosthetic thrombosis and cardiac computed tomography contribute in evaluation of leaflet's motion reduction in these cases.
Abstract
Background
Prosthetic heart valve (PHV) dysfunction is a serious complication. Echocardiography
remains the first-line imaging investigation to assess PHV dysfunction. However, the
role of Computed Tomography (CT) scanning in this type of case has not been thoroughly
studied yet.
The objective of our study was to determine if cardiac Computed Tomography (CT) had
a potentially complementary role to play alongside echocardiography in diagnosing
the mechanism of prosthetic valve dysfunction.
Methods and results
This prospective cohort study was conducted on 54 patients with suspected PHV dysfunction.
All patients underwent routine diagnosis work-up (transthoracic and transesophageal
echocardiography) and additional cardiac CT. Cardiac CT showed findings that were
not detected by echocardiography in seven patients (12%) namely aortic pannus (5)
and pseudoaneurysm (2). An underlying thrombus was detected by echocardiography and
missed by cardiac CT in 15 patients (27%). However, in these thrombotic cases, cardiac
CT contributed to the functional evaluation of leaflets.
Conclusion
This study demonstrates that an integrated approach including transthoracic, transesophageal
echocardiography and computed tomography is useful in patients with suspected PHV
dysfunction. While computed tomography is more accurate in the diagnosis of pannus
formation and periannular complications, echocardiography is superior at detecting
thrombus.
Keywords
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Article info
Publication history
Accepted:
February 13,
2023
Received in revised form:
January 31,
2023
Received:
November 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
