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Prosthetic heart valve assessment with 640-Slice MSCT: Initial Experience with 36 Prosthetic heart valv es
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Abstract
Objectives: Multislice CT(MSCT) has shown potential for prosthetic heart valve (PHV) assessment. We assessed the image quality of different PHV types to determine which PHV are suitable for MSCT evaluation and accuracy of 640-Slice MSCT for PHV dysfunction assessment.
Subjects and methods: Cardiac 640- Slice MSCT examinations performed at the Medic medical center since 6/2013 to12/2016 were reviewed for the presence of PHVs. Image quality of the supravalvular, perivalvular, subvalvular and valvular regions was scored on a four-point scale (1=non-diagnostic, 2= moderate, 3=good and 4=excellent). Causes of PHV dysfunction were confirmed by surgery.
Results: 28 patients with a total of 36 PHVs (4 monoleaflets, 25 bileaflets and 7 biological PHVs) in the aortic(n=22), mitral(n=14) position were included. Median image quality scores for the supra-,peri-and subvalvular regions and valvular detail were 4, 3.7, 3.7 and 3.5, respectively for bileaflet PHVs; 3, 2.6, 2.5 and 1.6, respectively for monoleaflet PHVs and 4, 3.8, 4.0 and 3.7 respectively for biological PHVs. In 3/4(75%) monoleaflet valves with severe artefacts and non - assessment. In 22(17
bileaflets and 5 biological PHVs ) of the 32 PHVs(68,75%) detect PHV dysfunction. In the PHV dysfunction group, the mechanism of dysfunction (pannus, thrombosis , patient prosthesis mismatch , paravalvular leakage, endocarditis and degenerate) was correctly identified by surgery in 100% of the cases.
Conclusion: Implanted bileaflet and biological PHVs have good image quality on 640-Slice MSCT and are suitable for 640-Slice MSCT evaluation. Causes of PHV dysfunction were correctly evaluated by 640-slice MSCT in all PHVs except for monoleaflet PHVs.
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References
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