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Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves

Jesse Habets1, Renee B A van den Brink, Ruben Uijlings

  • 1Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E01.132, PO BOX 85500, 3508 GA Utrecht, The Netherlands. J.Habets@umcutrecht.nl

European Radiology
|December 24, 2011
PubMed

Insights

Most prosthetic heart valves do not interfere with coronary artery assessment using multidetector CT. However, cobalt-chrome valves significantly hinder assessment due to artefacts, impacting diagnostic accuracy.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Biomedical Engineering

Background:

  • Patients with prosthetic heart valves often require evaluation for coronary artery disease (CAD).
  • Multidetector CT (MDCT) is a key imaging modality for assessing coronary arteries.
  • Prosthetic heart valves can potentially cause artefacts that interfere with MDCT imaging.

Purpose of the Study:

  • To evaluate the impact of prosthetic heart valve artefacts on coronary artery assessment using multidetector CT.
  • To determine if different prosthetic heart valve materials influence image quality and diagnostic capability.

Main Methods:

  • Retrospective analysis of ECG-gated or -triggered CT angiograms from patients with prosthetic heart valves.
  • Selection of optimal systolic and diastolic axial reconstructions for coronary assessment.
  • Scoring of coronary artery segments for the presence of valve-related artefacts by two independent observers.

Main Results:

  • 3.7% of coronary artery segments (43/1160) were non-diagnostic due to valve artefacts across 82 MDCT scans.
  • Artefacts were most prevalent in the right coronary artery (35%) and circumflex artery (32%) segments.
  • All cobalt-chrome containing valves caused significant artefacts, precluding coronary assessment, while most biological and titanium valves did not.

Conclusions:

  • Most commonly implanted prosthetic heart valves do not impede coronary artery assessment via MDCT.
  • Prosthetic heart valve material is a critical determinant of artefact occurrence.
  • Cobalt-chrome valves, specifically Björk-Shiley and Sorin tilting disc valves, significantly limit the diagnostic utility of MDCT for coronary artery assessment.
Abstract

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