Related Experiment Video
Updated: May 2, 2026
Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
Published on: January 20, 2022
Multidetector-row computed tomography allows accurate measurement of mechanical prosthetic heart valve leaflet
Dominika Suchá1, Petr Symersky, Evert-Jan P A Vonken
1From the *Department of Radiology, University Medical Center Utrecht, Utrecht; †Department of Cardiothoracic Surgery, Academic Medical Center Amsterdam, Amsterdam; and ‡Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Purpose:
The purpose of this study was to compare multidetector-row computed tomography (MDCT) leaflet restriction measurements with fluoroscopy measurements in commonly used mechanical prosthetic heart valves (PHVs).
Methods:
Four mechanical PHVs (ON-X, Carbomedics, St. Jude, and Medtronic Hall) were imaged in a pulsatile model using fluoroscopy and 64-detector-row computed tomography. Five image acquisitions of each PHV without (1) and with (4) restricted leaflet closure were made. Three observers measured closure angles on fluoroscopy and MDCT. Data were analyzed using intraclass correlation coefficient (ICC) and Bland-Altman plots.
Results:
Interobserver agreement was high in restricted and non-restricted leaflets on both modalities (ICCs >0.995). MDCT and fluoroscopy showed high agreements (ICCs >0.989). Median MDCT closure angle measurements differed at most -2 to +2 degrees from fluoroscopy in the restricted and -1 to +2 degrees in the non-restricted leaflets.
Conclusions:
MDCT allows measurement of leaflet motion with a maximal median discrepancy of 2 degrees. Both MDCT and fluoroscopy detect restricted leaflet closure with great accuracy.
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests