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Usefulness of cardiac computed tomography in prosthetic heart valve dysfunction

Kammoun Ikram1, Bennour Emna1, Karmous Rahma1

  • 1Department of Cardiology, Ariana Hospital, Tunisia.

Clinical Imaging
|May 5, 2023
PubMed

Insights

Cardiac computed tomography (CT) complements echocardiography for prosthetic heart valve (PHV) dysfunction. While CT excels at detecting pannus and pseudoaneurysms, echocardiography is superior for identifying thrombus.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Prosthetic heart valve (PHV) dysfunction is a significant clinical issue.
  • Echocardiography is the primary imaging modality for assessing PHV dysfunction.
  • The complementary role of cardiac Computed Tomography (CT) in PHV dysfunction requires further investigation.

Purpose of the Study:

  • To evaluate the potential complementary role of cardiac CT alongside echocardiography in diagnosing the mechanisms of prosthetic heart valve dysfunction.

Main Methods:

  • A prospective cohort study involving 54 patients with suspected PHV dysfunction.
  • All patients underwent standard echocardiography (transthoracic and transesophageal) and cardiac CT.
  • Comparison of findings between echocardiography and cardiac CT.

Main Results:

  • Cardiac CT identified previously undetected aortic pannus (5 patients) and pseudoaneurysm (2 patients) in 7 patients (12%).
  • Echocardiography detected thrombus in 15 patients (27%) missed by cardiac CT.
  • Cardiac CT provided functional leaflet evaluation in cases with thrombus.

Conclusions:

  • An integrated diagnostic approach combining echocardiography and cardiac CT is beneficial for suspected PHV dysfunction.
  • Cardiac CT demonstrates higher accuracy in diagnosing pannus formation and periannular complications.
  • Echocardiography remains the preferred method for thrombus detection.
Abstract

Keywords:
Computed tomographyEchocardiographyProsthetic heart valve

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