Multidetector CT angiography in evaluation of prosthetic heart valve dysfunction

Area of Science:

• Cardiovascular Imaging
• Medical Diagnostics
• Biomedical Engineering

Background:

• Prosthetic heart valves (PHVs) are crucial for treating valvular heart disease.
• PHV dysfunction can lead to severe complications.
• Current imaging methods like echocardiography and fluoroscopy have limitations in diagnosing PHV dysfunction causes due to acoustic shadowing.

Purpose of the Study:

• To evaluate multidetector computed tomographic (CT) angiography as a complementary imaging technique for prosthetic heart valves (PHVs).
• To highlight the advantages of CT angiography in diagnosing PHV dysfunction, particularly obstruction and endocarditis.
• To outline optimal CT acquisition and interpretation protocols for PHV assessment.

Main Methods:

• Utilized multidetector computed tomographic (CT) angiography for prosthetic heart valve (PHV) evaluation.
• Employed retrospectively electrocardiographically gated acquisition for dynamic leaflet assessment.
• Performed dedicated reconstructions in planes parallel and perpendicular to PHV leaflets for accurate interpretation.

Main Results:

• CT angiography demonstrates promise in evaluating PHVs, especially in cases of obstruction and endocarditis.
• Image quality is influenced by PHV composition, with most causing minimal artifacts.
• Electrocardiographically gated acquisition allows for comprehensive assessment of leaflet motion and valve anatomy in systole and diastole.

Conclusions:

• Multidetector computed tomographic (CT) angiography is a valuable complementary tool for diagnosing prosthetic heart valve (PHV) dysfunction.
• Optimal imaging requires specific acquisition and reconstruction techniques.
• Multidisciplinary collaboration is essential for maximizing the diagnostic utility of CT in PHV assessment.