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He A, Wilkins B, Lan NSR, Othman F, Sehly A, Bhat V, Jaltotage B, Dwivedi G, Leipsic J, Ihdayhid AR. Cardiac computed tomography post-transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr 2024; 18:319-326. [PMID: 38782668 DOI: 10.1016/j.jcct.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/25/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024]
Abstract
Transcatheter aortic valve replacement (TAVR) is performed to treat aortic stenosis and is increasingly being utilised in the low-to-intermediate-risk population. Currently, attention has shifted towards long-term outcomes, complications and lifelong maintenance of the bioprosthesis. Some patients with TAVR in-situ may develop significant coronary artery disease over time requiring invasive coronary angiography, which may be problematic with the TAVR bioprosthesis in close proximity to the coronary ostia. In addition, younger patients may require a second transcatheter heart valve (THV) to 'replace' their in-situ THV because of gradual structural valve degeneration. Implantation of a second THV carries a risk of coronary obstruction, thereby requiring comprehensive pre-procedural planning. Unlike in the pre-TAVR period, cardiac CT angiography in the post-TAVR period is not well established. However, post-TAVR cardiac CT is being increasingly utilised to evaluate mechanisms for structural valve degeneration and complications, including leaflet thrombosis. Post-TAVR CT is also expected to have a significant role in risk-stratifying and planning future invasive procedures including coronary angiography and valve-in-valve interventions. Overall, there is emerging evidence for post-TAVR CT to be eventually incorporated into long-term TAVR monitoring and lifelong planning.
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Affiliation(s)
- Albert He
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Department of Cardiology, Dunedin Public Hospital, Dunedin, New Zealand
| | - Ben Wilkins
- Department of Cardiology, Dunedin Public Hospital, Dunedin, New Zealand
| | - Nick S R Lan
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Farrah Othman
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia
| | - Amro Sehly
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia
| | - Vikas Bhat
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia
| | | | - Girish Dwivedi
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia; Medical School, University of Western Australia, Perth, Australia
| | - Jonathon Leipsic
- Department of Radiology, St Paul's Hospital, University of British Columbia, Vancouver, Canada
| | - Abdul Rahman Ihdayhid
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia; Medical School, Curtin University, Perth, Australia.
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2
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Zoghbi WA, Jone PN, Chamsi-Pasha MA, Chen T, Collins KA, Desai MY, Grayburn P, Groves DW, Hahn RT, Little SH, Kruse E, Sanborn D, Shah SB, Sugeng L, Swaminathan M, Thaden J, Thavendiranathan P, Tsang W, Weir-McCall JR, Gill E. Guidelines for the Evaluation of Prosthetic Valve Function With Cardiovascular Imaging: A Report From the American Society of Echocardiography Developed in Collaboration With the Society for Cardiovascular Magnetic Resonance and the Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 2024; 37:2-63. [PMID: 38182282 DOI: 10.1016/j.echo.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
In patients with significant cardiac valvular disease, intervention with either valve repair or valve replacement may be inevitable. Although valve repair is frequently performed, especially for mitral and tricuspid regurgitation, valve replacement remains common, particularly in adults. Diagnostic methods are often needed to assess the function of the prosthesis. Echocardiography is the first-line method for noninvasive evaluation of prosthetic valve function. The transthoracic approach is complemented with two-dimensional and three-dimensional transesophageal echocardiography for further refinement of valve morphology and function when needed. More recently, advances in computed tomography and cardiac magnetic resonance have enhanced their roles in evaluating valvular heart disease. This document offers a review of the echocardiographic techniques used and provides recommendations and general guidelines for evaluation of prosthetic valve function on the basis of the scientific literature and consensus of a panel of experts. This guideline discusses the role of advanced imaging with transesophageal echocardiography, cardiac computed tomography, and cardiac magnetic resonance in evaluating prosthetic valve structure, function, and regurgitation. It replaces the 2009 American Society of Echocardiography guideline on prosthetic valves and complements the 2019 guideline on the evaluation of valvular regurgitation after percutaneous valve repair or replacement.
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Affiliation(s)
- William A Zoghbi
- Houston Methodist Hospital, DeBakey Heart & Vascular Center, Houston, Texas.
| | - Pei-Ni Jone
- Lurie Children's Hospital, Northwestern University, Chicago, Illinois
| | | | - Tiffany Chen
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Milind Y Desai
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Paul Grayburn
- Baylor Scott & White Health, University of Texas Southwestern, Dallas, Texas
| | - Daniel W Groves
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Rebecca T Hahn
- Columbia University Irving Medical Center, New York, New York
| | - Stephen H Little
- Houston Methodist Hospital, DeBakey Heart & Vascular Center, Houston, Texas
| | - Eric Kruse
- University of Chicago Medical Center, Chicago, Illinois
| | | | - Sangeeta B Shah
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Lissa Sugeng
- North Shore University Hospital, Manhasset, New York
| | - Madhav Swaminathan
- Cardiothoracic Anesthesiology and Critical Care Medicine, Duke University, Durham, North Carolina
| | | | | | - Wendy Tsang
- University of Toronto, Toronto, Ontario, Canada
| | | | - Edward Gill
- University of Colorado School of Medicine, Aurora, Colorado
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3
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Faraj R, Diallo TH, Dib H, Sarsari M, Diafarou R, Zarzur J, Cherti M. Mechanical prosthetic mitral valve obstruction: Pannus or thrombus? A case report. Radiol Case Rep 2023; 18:2685-2688. [PMID: 37293521 PMCID: PMC10245095 DOI: 10.1016/j.radcr.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/10/2023] Open
Abstract
Substitution of a defective heart valve with a prosthetic heart valve turns the native disease for prosthesis-related complications. One of the most serious and dreaded complications is prosthetic valve obstruction. It is either the result of a thrombus or pannus formation. For the evaluation of prosthetic valve obstruction, transthoracic echography and fluoroscopy provide functional information but may not provide information about the etiology of the obstruction, unlike multidetector computed tomography (MDCT) which allows a more precise etiological diagnosis to guide the therapeutic attitude. Here, we report a case of a mechanical prosthetic mitral valve obstruction in a 45-year-old patient in whom the diagnosis of pannus was retained on the basis of clinical, biological, and imaging data. The differentiation between thrombus and pannus is crucial because it conditions the therapeutic attitude. Advanced imaging specially MDCT options should be considered whenever mechanical prosthesis valve obstruction is suspected.
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Affiliation(s)
- Raid Faraj
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Thierno Hamidou Diallo
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Hassan Dib
- Mohammed V University, Rabat, Morocco
- Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Morocco
| | - Mohamed Sarsari
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Raynatou Diafarou
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Jamila Zarzur
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
| | - Mohamed Cherti
- Mohammed V University, Rabat, Morocco
- Cardiology B department, Ibn Sina university hospital center, Rabat, Morocco
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4
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Soria Jiménez CE, Papolos AI, Kenigsberg BB, Ben-Dor I, Satler LF, Waksman R, Cohen JE, Rogers T. Management of Mechanical Prosthetic Heart Valve Thrombosis: JACC Review Topic of the Week. J Am Coll Cardiol 2023; 81:2115-2127. [PMID: 37225366 DOI: 10.1016/j.jacc.2023.03.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 05/26/2023]
Abstract
Mechanical prosthetic heart valves, though more durable than bioprostheses, are more thrombogenic and require lifelong anticoagulation. Mechanical valve dysfunction can be caused by 4 main phenomena: 1) thrombosis; 2) fibrotic pannus ingrowth; 3) degeneration; and 4) endocarditis. Mechanical valve thrombosis (MVT) is a known complication with clinical presentation ranging from incidental imaging finding to cardiogenic shock. Thus, a high index of suspicion and expedited evaluation are essential. Multimodality imaging, including echocardiography, cine-fluoroscopy, and computed tomography, is commonly used to diagnose MVT and follow treatment response. Although surgery is oftentimes required for obstructive MVT, other guideline-recommended therapies include parenteral anticoagulation and thrombolysis. Transcatheter manipulation of stuck mechanical valve leaflet is another treatment option for those with contraindications to thrombolytic therapy or prohibitive surgical risk or as a bridge to surgery. The optimal strategy depends on degree of valve obstruction and the patient's comorbidities and hemodynamic status on presentation.
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Affiliation(s)
- César E Soria Jiménez
- Division of Cardiology, MedStar Washington/Georgetown University Hospital Center, Washington, DC, USA
| | - Alexander I Papolos
- Division of Cardiology, MedStar Washington/Georgetown University Hospital Center, Washington, DC, USA; Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - Benjamin B Kenigsberg
- Division of Cardiology, MedStar Washington/Georgetown University Hospital Center, Washington, DC, USA; Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Lowell F Satler
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Jeffrey E Cohen
- Department of Cardiac Surgery, MedStar Washington Hospital Center, Washington, DC, USA
| | - Toby Rogers
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA; Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
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5
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Abdelghani M, Abdelfattah M, Diab AM, Elsheikh H, Elabbady MEM. Computed tomography vs. cinefluoroscopy for the assessment of mechanical prosthetic valve leaflet motion. Heart Vessels 2023; 38:599-605. [PMID: 36301342 DOI: 10.1007/s00380-022-02193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/13/2022] [Indexed: 11/26/2022]
Abstract
Evaluation of mechanical prosthetic valve function is based on echocardiography, but adequate assessment of leaflet motion is limited by acoustic shadowing. Cinefluoroscopy is a standard method to assess leaflet motion, while computed tomography (CT) has been suggested as an alternative. We sought to compare the feasibility of leaflet motion assessment by cinefluoroscopy vs. CT. In 35 prospectively enrolled patients, leaflet motion was assessed in 43 bileaflet mechanical prostheses (29 mitral and 14 aortic) by cinefluoroscopy and non-contrast CT. Assessment was considered feasible when the 'in profile' projection (with the radiographic beam parallel to both the valve ring plane and the tilting axis of discs) could be achieved. Overall feasibility of fluoroscopic assessment was 74% (mitral, 66% vs. aortic, 93%; p = 0.071), while feasibility of CT assessment was 100% (p = 0.003). Among prostheses with unfeasible fluoroscopic assessment, CT suggested an extreme C-arm angulation to achieve the "in profile" projection (RAO: 76.0 ± 5.8°, LAO: 122.7 ± 32.5°, CRA: 51.4 ± 16.0°, CAU: 57.0 ± 18.2°). Among prostheses with feasible assessment by both techniques, fluoroscopy and CT yielded similar opening and closing angles (intraclass correlation coefficient, 0.959-0.998) with lower irradiation with CT as compared with fluoroscopy (26.2[21.1-29.3] vs. 289[179-358] mGy, p < 0.001). While CT scan took 8.7 ± 0.5 s, fluoroscopy required 2.64 ± 1.56 min to achieve and record the "in profile" projection. Non-contrast CT provides a higher feasibility and a quicker evaluation of mechanical prosthetic valve leaflet motion with less irradiation than fluoroscopy, especially in mitral valve position.
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Affiliation(s)
- Mohammad Abdelghani
- Cardiology Department, Al-Azhar University, Cairo, Egypt.
- Cardiology Department, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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6
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Kim K, Kim DY, Seo J, Cho I, Shim CY, Hong GR, Ha JW. The ratio of measured and reference effective orifice areas for discriminating prosthetic aortic valve obstruction. Eur Heart J Cardiovasc Imaging 2023; 24:232-240. [PMID: 36315445 DOI: 10.1093/ehjci/jeac206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 01/25/2023] Open
Abstract
AIMS We aimed to evaluate the efficacy of the measured effective orifice area (EOA)/reference EOA ratio in discriminating mechanical prosthetic aortic valve (PAV) obstruction. METHODS AND RESULTS This is a retrospective study of 193 mechanical PAV patients with an elevated mean transprosthetic pressure gradient (PG) over 20 mmHg or peak velocity over 3 m/s. Of those, 143 patients were objectively proven PAV obstruction with cardiac computed tomography or surgical inspection. The EOA was measured using the continuity equation, and the reference EOA values were obtained from previous guidelines. The measured/reference EOA ratio was significantly lower in the obstruction group (0.63 ± 0.18 vs. 0.86 ± 0.17; P < 0.001). The EOA ratio added incremental value for discriminating obstruction from the conventional parameters recommended in the guidelines. Receiver operating characteristic curve analysis revealed that the measured/reference EOA ratio discriminated PAV obstruction from those without obstruction [area under the curve (AUC), 0.840; 95% confidence interval, 0.783-0.898; P < 0.001]. A cutoff of 0.71 had 73.4% sensitivity and 82.0% specificity. The novel diagnostic algorithm adding the EOA ratio had similar accuracy to previous guideline algorithms, including reference EOA, and conventional Doppler parameters (AUC, 0.763 vs. 0.731; P = 0.309). In patients with a large PAV (≥23 mm), the novel algorithm had higher accuracy than the previous algorithm (AUC, 0.788 vs. 0.642; P = 0.019). CONCLUSION The ratio of measured/reference EOA adds incremental value over conventional Doppler parameters and might be helpful for distinguishing PAV obstruction.
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Affiliation(s)
- Kyu Kim
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Dae-Young Kim
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Jiwon Seo
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Iksung Cho
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Chi Young Shim
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Geu-Ru Hong
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Jong-Won Ha
- Division of Cardiology, Severance Hospital Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
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7
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2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Thorac Cardiovasc Surg 2021; 162:e183-e353. [PMID: 33972115 DOI: 10.1016/j.jtcvs.2021.04.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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8
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Malik SB, Hsu JY, Hurwitz Koweek LM, Ghoshhajra BB, Beache GM, Brown RKJ, Davis AM, Johri AM, Kligerman SJ, Litmanovich D, Mace SE, Maroules CD, Meyersohn N, Villines TC, Wann S, Weissman G, Abbara S. ACR Appropriateness Criteria® Infective Endocarditis. J Am Coll Radiol 2021; 18:S52-S61. [PMID: 33958118 DOI: 10.1016/j.jacr.2021.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/20/2021] [Indexed: 11/25/2022]
Abstract
Infective endocarditis can involve a normal, abnormal, or prosthetic cardiac valve. The diagnosis is typically made clinically with persistently positive blood cultures, characteristic signs and symptoms, and echocardiographic evidence of valvular vegetations or valvular complications such as abscess, dehiscence, or new regurgitation. Imaging plays an important role in the initial diagnosis of infective endocarditis, identifying complications, prognostication, and informing the next steps in therapy. This document outlines the initial imaging appropriateness of a patient with suspected infective endocarditis and for additional imaging in a patient with known or suspected infective endocarditis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Sachin B Malik
- Research Author, VA Palo Alto Health Care System, Palo Alto, California and Stanford University, Stanford, California, Section Chief Thoracic and Cardiovascular Imaging, Director of Stress Cardiac MRI Program, Director of Cardiovascular CT and MRI.
| | - Joe Y Hsu
- Kaiser Permanente, Los Angeles, California
| | - Lynne M Hurwitz Koweek
- Panel Chair, Duke University Medical Center, Durham, North Carolina, Director, Cardiovascular Imaging, Medical Director of CT, Duke University Medical Center
| | | | - Garth M Beache
- University of Louisville School of Medicine, Louisville, Kentucky
| | - Richard K J Brown
- University of Utah, Department of Radiology and Imaging Sciences, Salt Lake City, Utah
| | - Andrew M Davis
- The University of Chicago Medical Center, Chicago, Illinois, American College of Physicians
| | - Amer M Johri
- Queen's University, Kingston, Ontario, Canada, Cardiology expert
| | | | - Diana Litmanovich
- Harvard Medical School, Boston, Massachusetts, Section Chief of the Cardiothoracic Section, Department of Radiology, Beth Israel Deaconess Medical Center; President of the North American Society for Cardiovascular Imaging and Co-Chair of Image Wisely
| | - Sharon E Mace
- Cleveland Clinic, Cleveland, Ohio, American College of Emergency Physicians
| | | | | | - Todd C Villines
- University of Virginia Health Center, Charlottesville, Virginia, Society of Cardiovascular Computed Tomography
| | - Samuel Wann
- Ascension Healthcare Wisconsin, Milwaukee, Wisconsin, Nuclear cardiology expert
| | - Gaby Weissman
- Medstar Washington Hospital Center, Georgetown University, Washington, District of Columbia, Society for Cardiovascular Magnetic Resonance, Medstar Heart and Vascular Institute, Associate Professor of Medicine and Radiology
| | - Suhny Abbara
- Specialty Chair, UT Southwestern Medical Center, Dallas, Texas
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9
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Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM, Thompson A, Toly C. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 143:e72-e227. [PMID: 33332150 DOI: 10.1161/cir.0000000000000923] [Citation(s) in RCA: 555] [Impact Index Per Article: 185.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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10
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Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM, Thompson A, Toly C. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 143:e35-e71. [PMID: 33332149 DOI: 10.1161/cir.0000000000000932] [Citation(s) in RCA: 353] [Impact Index Per Article: 117.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AIM This executive summary of the valvular heart disease guideline provides recommendations for clinicians to diagnose and manage valvular heart disease as well as supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from January 1, 2010, to March 1, 2020, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, Cochrane, Agency for Healthcare Research and Quality Reports, and other selected database relevant to this guideline. Structure: Many recommendations from the earlier valvular heart disease guidelines have been updated with new evidence and provides newer options for diagnosis and treatment of valvular heart disease. This summary includes only the recommendations from the full guideline which focus on diagnostic work-up, the timing and choice of surgical and catheter interventions, and recommendations for medical therapy. The reader is referred to the full guideline for graphical flow charts, text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in developing these guidelines.
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11
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Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O'Gara PT, Rigolin VH, Sundt TM, Thompson A, Toly C. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2021; 77:e25-e197. [PMID: 33342586 DOI: 10.1016/j.jacc.2020.11.018] [Citation(s) in RCA: 837] [Impact Index Per Article: 279.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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12
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Otto CM, Nishimura RA, Bonow RO, Carabello BA, Erwin JP, Gentile F, Jneid H, Krieger EV, Mack M, McLeod C, O’Gara PT, Rigolin VH, Sundt TM, Thompson A, Toly C. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary. J Am Coll Cardiol 2021; 77:450-500. [DOI: 10.1016/j.jacc.2020.11.035] [Citation(s) in RCA: 272] [Impact Index Per Article: 90.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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13
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Senapati A, Faza NN, Mahmarian J, Chang SM. Cardiac Computed Tomography for Structural Heart Disease Assessment and Therapeutic Planning: Focus on Prosthetic Valve Dysfunction. Methodist Debakey Cardiovasc J 2020; 16:86-96. [PMID: 32670468 DOI: 10.14797/mdcj-16-2-86] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Of the 100,000-plus valve surgeries performed each year in the United States, up to 6% of those develop complications from prosthetic valve dysfunction. Prosthetic valve dysfunction (PVD) can be life threatening and often challenging to diagnose. In this review, we discuss the prevalence and incidence of PVD, explore its different etiologies, and assess the role of multimodality imaging with an emphasis on cardiac multidetector computed tomography (MDCT) for evaluating patients with PVD. We also investigate the utility of MDCT in preprocedural planning for transcatheter devices and redo surgical planning and discuss management strategies for patients with PVD.
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Affiliation(s)
- Alpana Senapati
- METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
| | - Nadeen N Faza
- METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON METHODIST HOSPITAL, HOUSTON, TEXAS
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14
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Gündüz S, Kalçık M, Gürsoy MO, Güner A, Özkan M. Diagnosis, treatment & management of prosthetic valve thrombosis: the key considerations. Expert Rev Med Devices 2020; 17:209-221. [DOI: 10.1080/17434440.2020.1733972] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Sabahattin Gündüz
- Department of Cardiology, VM Medikal Park Pendik Hospital, Istanbul, Turkey
| | - Macit Kalçık
- Department of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Mustafa Ozan Gürsoy
- Department of Cardiology, Izmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey
| | - Ahmet Güner
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training & Research Hospital, Istanbul, Turkey
| | - Mehmet Özkan
- Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
- School of Health Sciences, Ardahan University, Ardahan, Turkey
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15
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Park MY, Koo HJ, Ha H, Kang JW, Yang DH. Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:1151-1163. [PMID: 36238048 PMCID: PMC9431869 DOI: 10.3348/jksr.2019.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 11/23/2022]
Abstract
Purpose This study aimed to evaluate changes of subprosthetic pannus on cardiac CT and determine its relationship to echocardiographic findings in patients with mechanical aortic valve replacement (AVR). Materials and Methods Between April 2011 and November 2017, 17 AVR patients (56.8 ± 8.9 years, 12% male) who showed pannus formation on CT and had undergone both follow-up CT and echocardiography were included. The mean interval from AVR to the date of pannus detection was 10.5 ± 7.1 years. In the initial and follow-up CT and echocardiography, the pannus extent and echocardiographic parameters were compared using paired t-tests. The relationship between the opening angle of the prosthetic valve and the pannus extent was evaluated using Pearson correlation analysis. Results The pannus extent was significantly increased on CT (p < 0.05). The peak velocity (3.9 ± 0.8 m/s vs. 4.2 ± 0.8 m/s, p = 0.03) and mean pressure gradient (36.4 ± 15.5 mm Hg vs. 42.1 ± 15.8 mm Hg, p = 0.03) were significantly increased. The mean opening angles of the mechanical aortic leaflets were slightly decreased, but there was no statistical significance (73.1 ± 8.3° vs. 69.4 ± 12.1°, p = 0.12). The opening angle of the prosthetic leaflets was inversely correlated with the pannus extent (r = −0.57, p < 0.001). Conclusion The pannus extent increases over time, increasing transvalvular peak velocity and the pressure gradient. CT can be used to evaluate the pannus extent associated with hemodynamic changes that need to be managed by surgical intervention.
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Affiliation(s)
- Mi Yeon Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Cardiac Imaging Center, Asan Medical Center, Seoul, Korea
| | - Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Cardiac Imaging Center, Asan Medical Center, Seoul, Korea
| | - Hojin Ha
- Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Korea
| | - Joon-Won Kang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Cardiac Imaging Center, Asan Medical Center, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Cardiac Imaging Center, Asan Medical Center, Seoul, Korea
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Kim JY, Suh YJ, Han K, Kim YJ, Choi BW. Diagnostic Value of Advanced Imaging Modalities for the Detection and Differentiation of Prosthetic Valve Obstruction. JACC Cardiovasc Imaging 2019; 12:2182-2192. [DOI: 10.1016/j.jcmg.2018.11.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 11/19/2018] [Accepted: 11/28/2018] [Indexed: 01/18/2023]
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Kalçık M, Güner A, Yesin M, Bayam E, Kalkan S, Gündüz S, Gürsoy MO, Karakoyun S, Cerşit S, Özkan M. Identification of mechanical prosthetic heart valves based on distinctive cinefluoroscopic and echocardiographic markers. Int J Artif Organs 2019; 42:603-610. [PMID: 31269859 DOI: 10.1177/0391398819860845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The past 65 years have witnessed remarkable progress in the development of safe, hemodynamically favorable mechanical heart valves. Today, there are a large number and variety of prostheses in use and many prostheses have been used for a while and then discontinued. When patients lack reliable information about their heart valve prostheses, identification of valve model becomes difficult even for specialized physicians in this area. A combination of cinefluoroscopy and echocardiography makes it possible to provide accurate and detailed information regarding identification of prosthetic valve models. Fluoroscopic examination is a useful technique to evaluate patients following mechanical heart valve replacement. However, transthoracic echocardiography and transesophageal echocardiography have almost replaced cinefluoroscopy in the evaluation of prosthetic heart valves. Especially, real-time three-dimensional transesophageal echocardiography provides distinctive images of prosthetic heart valves, particularly for those in the mitral position. A large body of literature has been published to familiarize physicians with the radiological appearance of numerous mechanical prostheses. However, there is a lack of data regarding the identification of prosthetic valve models based on echocardiographic appearance. In this review, we aimed to describe distinctive echocardiographic and cinefluoroscopic markers for identifying the type and brand of several commonly used mechanical prosthetic heart valves.
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Affiliation(s)
- Macit Kalçık
- Department of Cardiology, Faculty of Medicine, Hitit University, Çorum, Turkey
| | - Ahmet Güner
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Mahmut Yesin
- Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey
| | - Emrah Bayam
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Semih Kalkan
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Sabahattin Gündüz
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Ozan Gürsoy
- Department of Cardiology, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, Izmir, Turkey
| | - Süleyman Karakoyun
- Department of Cardiology, Faculty of Medicine, Kars Kafkas University, Kars, Turkey
| | - Sinan Cerşit
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Özkan
- Department of Cardiology, Koşuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.,Division of Health Sciences, Ardahan University, Ardahan, Turkey
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Rajiah P, Moore A, Saboo S, Goerne H, Ranganath P, MacNamara J, Joshi P, Abbara S. Multimodality Imaging of Complications of Cardiac Valve Surgeries. Radiographics 2019; 39:932-956. [PMID: 31150303 DOI: 10.1148/rg.2019180177] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Replacement with a prosthetic heart valve (PHV) remains the definitive surgical procedure for management of severe cardiac valve disease. PHV dysfunction is uncommon but can be a life-threatening condition. The broad hemodynamic and pathophysiologic manifestations of PHV dysfunction are stenosis, regurgitation, and a stuck leaflet. Specific structural abnormalities that cause PHV dysfunction include prosthetic valve-patient mismatch, structural failure, valve calcification, dehiscence, paravalvular leak, infective endocarditis, abscess, pseudoaneurysm, abnormal connections, thrombus, hypoattenuating leaflet thickening, and pannus. Multiple imaging modalities are available for evaluating a PHV and its dysfunction. Transthoracic echocardiography is often the first-line imaging modality, with additional modalities such as transesophageal echocardiography, CT, MRI, cine fluoroscopy, and nuclear medicine used for further characterization and establishing a specific cause. The authors review PHVs and the role of imaging modalities in evaluation of PHV dysfunction and illustrate the imaging appearances of different complications. Online supplemental material is available for this article. ©RSNA, 2019.
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Affiliation(s)
- Prabhakar Rajiah
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - Alastair Moore
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - Sachin Saboo
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - Harold Goerne
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - Praveen Ranganath
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - James MacNamara
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - Parag Joshi
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
| | - Suhny Abbara
- From the Department of Radiology, Division of Cardiothoracic Imaging (P. Rajiah, A.M., S.S., H.G., P. Ranganath., S.A.), and Department of Cardiology (J.M., P.J.), UT Southwestern Medical Center, 5323 Harry Hines Blvd, E6.122G, Mail Code 9316, Dallas, TX 75390-8896; Department of Radiology, UT Health Science Center, San Antonio, Tex (S.S.); IMSS Centro Medico Nacional de Occidente, Guadalajara, Mexico (H.G.); and CID Imaging and Diagnostic Center, Guadalajara, Mexico (H.G.)
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Freitas-Ferraz AB, Beaudoin W, Couture C, Perron J, Sénéchal M. Reply to the Letter to the Editor: Noninvasive diagnostic tools available for discrimination of pannus from thrombus in patients with prosthetic valve dysfunction. Echocardiography 2019; 36:1224-1225. [PMID: 31025763 DOI: 10.1111/echo.14347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Afonso B Freitas-Ferraz
- Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - William Beaudoin
- Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Christian Couture
- Department of Pathology, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Jean Perron
- Department of Cardiac Surgery, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
| | - Mario Sénéchal
- Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada
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Androulakis I, Faure ME, Budde RPJ, van Walsum T. Automated Quantification of Bileaflet Mechanical Heart Valve Leaflet Angles in CT Images. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:753-761. [PMID: 30235123 DOI: 10.1109/tmi.2018.2871366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Cardiac computed tomography (CT) is a valuable tool for functional mechanical heart valve (MHV) assessment. An important aspect of bileaflet MHV assessment is evaluation and measurement of leaflet opening and closing angles. Performed manually, however, it is a laborious and time consuming task. In this paper, we propose an automated approach for bileaflet MHV leaflet angle computation. This method consists of four steps. After a one click selection of the MHV region on an axial image, an automatic MHV extraction using thresholding, and a connected component analysis based on voxel intensities is performed. Then, the MHV component (valve ring and two leaflets) positions are identified using random sample consensus and least square fitting. Finally, the angles are automatically computed based on the orientation of the components in each timeframe. Five multiphase CT scans from patients with a bileaflet MHV containing between 14 and 17 timepoints were used for development and another 15 were used for evaluation. The detected MHV components were scored for their overlap with real components as successful or unsuccessful. For successful results, the angles were compared to those measured by a radiologist. Qualitatively evaluated on a data set of 222 images, a total of 398 out of 444 angle computations (89.6%) were rated as successful. Compared to the angles measured by the radiologist, the successful angles showed a mean difference of 0.54° ± 3.63° from the manual calculations. The method provides a high success rate and an accurate computation of leaflet opening angles compared to manual measurements.
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21
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Koo HJ, Ha H, Kang JW, Kim JA, Song JK, Kim HJ, Lim TH, Yang DH. Impact of pannus formation on hemodynamic dysfunction of prosthetic aortic valve: pannus extent and its relationship to prosthetic valve motion and degree of stenosis. Clin Res Cardiol 2018; 107:554-564. [DOI: 10.1007/s00392-018-1217-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/14/2018] [Indexed: 01/17/2023]
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22
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Matiasz R, Rigolin VH. 2017 Focused Update for Management of Patients With Valvular Heart Disease: Summary of New Recommendations. J Am Heart Assoc 2018. [PMCID: PMC5778970 DOI: 10.1161/jaha.117.007596] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Richard Matiasz
- Division of Cardiology, Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Vera H. Rigolin
- Division of Cardiology, Department of Medicine, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL
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23
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The clinical significance of perivalvular pannus in prosthetic mitral valves: Can cardiac CT be helpful? Int J Cardiol 2017; 249:344-348. [DOI: 10.1016/j.ijcard.2017.09.169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 06/12/2017] [Accepted: 09/18/2017] [Indexed: 11/20/2022]
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24
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Suh YJ, Kim YJ, Kim JY, Chang S, Im DJ, Hong YJ, Choi BW. A whole-heart motion-correction algorithm: Effects on CT image quality and diagnostic accuracy of mechanical valve prosthesis abnormalities. J Cardiovasc Comput Tomogr 2017; 11:474-481. [PMID: 28966103 DOI: 10.1016/j.jcct.2017.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/16/2017] [Accepted: 09/19/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to determine the effect of a whole-heart motion-correction algorithm (new-generation snapshot freeze, NG SSF) on the image quality of cardiac computed tomography (CT) images in patients with mechanical valve prostheses compared to standard images without motion correction and to compare the diagnostic accuracy of NG SSF and standard CT image sets for the detection of prosthetic valve abnormalities. METHODS A total of 20 patients with 32 mechanical valves who underwent wide-coverage detector cardiac CT with single-heartbeat acquisition were included. The CT image quality for subvalvular (below the prosthesis) and valvular regions (valve leaflets) of mechanical valves was assessed by two observers on a four-point scale (1 = poor, 2 = fair, 3 = good, and 4 = excellent). Paired t-tests or Wilcoxon signed rank tests were used to compare image quality scores and the number of diagnostic phases (image quality score≥3) between the standard image sets and NG SSF image sets. Diagnostic performance for detection of prosthetic valve abnormalities was compared between two image sets with the final diagnosis set by re-operation or clinical findings as the standard reference. RESULTS NG SSF image sets had better image quality scores than standard image sets for both valvular and subvalvular regions (P < 0.05 for both). The number of phases that were of diagnostic image quality per patient was significantly greater in the NG SSF image set than standard image set for both valvular and subvalvular regions (P < 0.0001). Diagnostic performance of NG SSF image sets for the detection of prosthetic abnormalities (20 pannus and two paravalvular leaks) was greater than that of standard image sets (P < 0.05). CONCLUSION Application of NG SSF can improve CT image quality and diagnostic accuracy in patients with mechanical valves compared to standard images.
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Affiliation(s)
- Young Joo Suh
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea.
| | - Jin Young Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Suyon Chang
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Dong Jin Im
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Yoo Jin Hong
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
| | - Byoung Wook Choi
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, South Korea
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25
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Lim WY, Lloyd G, Bhattacharyya S. Mechanical and surgical bioprosthetic valve thrombosis. Heart 2017; 103:1934-1941. [DOI: 10.1136/heartjnl-2017-311856] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 11/04/2022] Open
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Absolute-Delay Multiphase Reconstruction Reduces Prosthetic Valve–Related and Atrial Fibrillation–Related Artifacts at Cardiac CT. AJR Am J Roentgenol 2017; 208:W160-W167. [DOI: 10.2214/ajr.16.16839] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM, Thompson A. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation 2017; 135:e1159-e1195. [PMID: 28298458 DOI: 10.1161/cir.0000000000000503] [Citation(s) in RCA: 1411] [Impact Index Per Article: 201.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | | | - Robert O Bonow
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Blase A Carabello
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - John P Erwin
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Lee A Fleisher
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Hani Jneid
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Michael J Mack
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Christopher J McLeod
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Patrick T O'Gara
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Vera H Rigolin
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Thoralf M Sundt
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
| | - Annemarie Thompson
- Focused Update writing group members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. ACC/AHA Representative. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. SCAI Representative. STS Representative. ASE Representative. AATS Representative. SCA Representative
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Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM, Thompson A. 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2017; 70:252-289. [PMID: 28315732 DOI: 10.1016/j.jacc.2017.03.011] [Citation(s) in RCA: 1841] [Impact Index Per Article: 263.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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29
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Koo HJ, Lee HN, Anh TT, Kang JW, Yang DH, Song JK, Kang DH, Song JM, Lee JW, Chung CH, Choo SJ, Lim TH. Postoperative Complications after Surgical Aortic Valve Replacement. ACTA ACUST UNITED AC 2017. [DOI: 10.22468/cvia.2017.00115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Hyun Jung Koo
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Han Na Lee
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Tran ThiXuan Anh
- Department of Cardiology, University Medical Center, Ho Chi Minh, Vietnam
| | - Joon-Won Kang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae-Kwan Song
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Duk-Hyun Kang
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Min Song
- Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Cardiothoracic Surgery, Asan Medical Center, Seoul, Korea
| | - Cheol Hyun Chung
- Department of Cardiothoracic Surgery, Asan Medical Center, Seoul, Korea
| | - Suk-Jung Choo
- Department of Cardiothoracic Surgery, Asan Medical Center, Seoul, Korea
| | - Tae-Hwan Lim
- Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Suchá D, Symersky P, van den Brink RB, Tanis W, Laufer EM, Meijs MF, Habets J, de Mol BA, Mali WP, Chamuleau SA, van Herwerden LA, Budde RP. Diagnostic evaluation and treatment strategy in patients with suspected prosthetic heart valve dysfunction: The incremental value of MDCT. J Cardiovasc Comput Tomogr 2016; 10:398-406. [DOI: 10.1016/j.jcct.2016.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 11/30/2022]
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Suh YJ, Lee S, Im DJ, Chang S, Hong YJ, Lee HJ, Hur J, Choi BW, Chang BC, Shim CY, Hong GR, Kim YJ. Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference. Int J Cardiol 2016; 214:454-60. [DOI: 10.1016/j.ijcard.2016.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 03/11/2016] [Accepted: 04/02/2016] [Indexed: 12/12/2022]
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Suh YJ, Hong GR, Han K, Im DJ, Chang S, Hong YJ, Lee HJ, Hur J, Choi BW, Chang BC, Shim CY, Kim YJ. Assessment of Mitral Paravalvular Leakage After Mitral Valve Replacement Using Cardiac Computed Tomography. Circ Cardiovasc Imaging 2016; 9:CIRCIMAGING.115.004153. [DOI: 10.1161/circimaging.115.004153] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 01/28/2016] [Indexed: 11/16/2022]
Abstract
Background—
The diagnostic performance of cardiac computed tomography (CT) for detection of paravalvular leakage (PVL) after mitral valve replacement has not been investigated in a large population. We aimed to investigate the diagnostic accuracy of CT for diagnosis of mitral PVL using surgical findings as the standard reference and to compare the diagnostic performance of CT with those of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE).
Methods and Results—
A total of 204 patients with previous mitral valve replacement who underwent cardiac CT were retrospectively included. The presence of mitral PVL was analyzed on CT, TTE, and TEE. In 78 patients who underwent redo-surgery, diagnostic performance for the detection of PVL for CT, TTE, and TEE were compared with surgical findings as the standard reference. The location of mitral PVL on CT and TEE was compared with surgical findings. Mitral PVL was present in 18.1% (37/204) on CT, in 16.2% (32/198) on TTE, and in 42.6% (29/68) on TEE. On the surgical field, PVL was identified in 41.0% (32/78). The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for detection of PVL were 96.9%, 97.8%, 96.9%, 97.8%, and 97.4% for CT; 81.3%, 95.6%, 92.9%, 87.8%, and 89.6% for TTE; and 96.2%, 95.8%, 96.2%, 95.8%, and 96.0% for TEE. CT and TEE identified the correct location of PVL in 75.9% (22/29) and 85.6% (19/23).
Conclusions—
Cardiac CT may have better diagnostic accuracy compared with TTE for the detection of mitral PVL and may be comparable to TEE for the detection and localization of PVL.
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Affiliation(s)
- Young Joo Suh
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Geu-Ru Hong
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Kyunghwa Han
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Dong Jin Im
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Suyon Chang
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Yoo Jin Hong
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Hye-Jeong Lee
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Jin Hur
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Byoung Wook Choi
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Byung-Chul Chang
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Chi Young Shim
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
| | - Young Jin Kim
- From the Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Y.J.S., K.H., D.J.I., S.C., Y.J.H., H.-J.L., J.H., B.W.C., Y.J.K.), Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital (G.-R.H., C.Y.S.), Department of Cardiovascular Surgery, Severance Cardiovascular Hospital (B.-C.C.), and Biostatistics Collaboration Unit (K.H.), Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea
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Andreini D, Martuscelli E, Guaricci AI, Carrabba N, Magnoni M, Tedeschi C, Pelliccia A, Pontone G. Clinical recommendations on Cardiac-CT in 2015. J Cardiovasc Med (Hagerstown) 2016; 17:73-84. [DOI: 10.2459/jcm.0000000000000318] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Chaikriangkrai K, Maragiannis D, Belousova T, Little S, Nabi F, Mahmarian J, Chang SM. Clinical Utility of Multidetector Computed Tomography in Redo Valve Procedures. J Card Surg 2016; 31:139-46. [DOI: 10.1111/jocs.12694] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Dimitrios Maragiannis
- Methodist DeBakey Heart & Vascular Center; Houston Methodist Hospital; Houston Texas
| | - Tatiana Belousova
- Methodist DeBakey Heart & Vascular Center; Houston Methodist Hospital; Houston Texas
| | - Stephen Little
- Methodist DeBakey Heart & Vascular Center; Houston Methodist Hospital; Houston Texas
| | - Faisal Nabi
- Methodist DeBakey Heart & Vascular Center; Houston Methodist Hospital; Houston Texas
| | - John Mahmarian
- Methodist DeBakey Heart & Vascular Center; Houston Methodist Hospital; Houston Texas
| | - Su Min Chang
- Methodist DeBakey Heart & Vascular Center; Houston Methodist Hospital; Houston Texas
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Factors affecting computed tomography image quality for assessment of mechanical aortic valves. Int J Cardiovasc Imaging 2015; 32 Suppl 1:63-71. [DOI: 10.1007/s10554-015-0817-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
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Sixty-Four–Section Cardiac Computed Tomography in Mechanical Prosthetic Heart Valve Dysfunction. Circ Cardiovasc Imaging 2015; 8:CIRCIMAGING.115.003246. [DOI: 10.1161/circimaging.115.003246] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Biteker M, Altun I, Basaran O, Dogan V, Yildirim B, Ergun G. Treatment of Prosthetic Valve Thrombosis: Current Evidence and Future Directions. J Clin Med Res 2015; 7:932-6. [PMID: 26566406 PMCID: PMC4625813 DOI: 10.14740/jocmr2392w] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 11/22/2022] Open
Abstract
Prosthetic heart valve thrombosis (PVT) is a rare but serious complication with high morbidity and mortality. The optimal treatment of the PVT is controversial and depends on thrombus location and size, the patient’s functional class, the risk of surgery or thrombolysis, and the clinician’s experience. Although surgical therapy has been the traditional therapeutic approach, studies with low-dose and slow-infusion rates of thrombolytic agents have revealed excellent results. This article reviews the various treatment options in patient with PVT.
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Affiliation(s)
- Murat Biteker
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Ibrahim Altun
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Ozcan Basaran
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Volkan Dogan
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Birdal Yildirim
- Department of Emergency Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Gokhan Ergun
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
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Suchá D, Chamuleau SAJ, Symersky P, Meijs MFL, van den Brink RBA, de Mol BAJM, Mali WPTM, Habets J, van Herwerden LA, Budde RPJ. Baseline MDCT findings after prosthetic heart valve implantation provide important complementary information to echocardiography for follow-up purposes. Eur Radiol 2015; 26:997-1006. [PMID: 26474984 PMCID: PMC4778148 DOI: 10.1007/s00330-015-3918-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/27/2015] [Accepted: 06/17/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Recent studies have proposed additional multidetector-row CT (MDCT) for prosthetic heart valve (PHV) dysfunction. References to discriminate physiological from pathological conditions early after implantation are lacking. We present baseline MDCT findings of PHVs 6 weeks post implantation. METHODS Patients were prospectively enrolled and TTE was performed according to clinical guidelines. 256-MDCT images were systematically assessed for leaflet excursions, image quality, valve-related artefacts, and pathological and additional findings. RESULTS Forty-six patients were included comprising 33 mechanical and 16 biological PHVs. Overall, MDCT image quality was good and relevant regions remained reliably assessable despite mild-moderate PHV-artefacts. MDCT detected three unexpected valve-related pathology cases: (1) prominent subprosthetic tissue, (2) pseudoaneurysm and (3) extensive pseudoaneurysms and valve dehiscence. The latter patient required valve surgery to be redone. TTE only showed trace periprosthetic regurgitation, and no abnormalities in the other cases. Additional findings were: tilted aortic PHV position (n = 3), pericardial haematoma (n = 3) and pericardial effusion (n = 3). Periaortic induration was present in 33/40 (83 %) aortic valve patients. CONCLUSIONS MDCT allowed evaluation of relevant PHV regions in all valves, revealed baseline postsurgical findings and, despite normal TTE findings, detected three cases of unexpected, clinically relevant pathology. KEY POINTS • Postoperative MDCT presents baseline morphology relevant for prosthetic valve follow-up. • 83 % of patients show periaortic induration 6 weeks after aortic valve replacement. • MDCT detected three cases of clinically relevant pathology not found with TTE. • Valve dehiscence detection by MDCT required redo valve surgery in one patient. • MDCT is a suitable and complementary imaging tool for follow-up purposes.
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Affiliation(s)
- Dominika Suchá
- Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Steven A J Chamuleau
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Petr Symersky
- Department of Cardiothoracic Surgery, VU Medical Center, Amsterdam, The Netherlands
| | - Matthijs F L Meijs
- Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands
| | | | - Bas A J M de Mol
- Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Willem P Th M Mali
- Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Jesse Habets
- Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Lex A van Herwerden
- Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ricardo P J Budde
- Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands.,Department of Radiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Peeters FECM, Kietselaer BLJH. Editorial to: Baseline MDCT findings after prosthetic heart valve implantation provide important complementary information to echocardiography for follow-up purposes by Suchá et al. Eur Radiol 2015; 26:1007-8. [PMID: 26474985 DOI: 10.1007/s00330-015-3937-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 06/29/2015] [Indexed: 11/25/2022]
Abstract
Over the last years a growing number of prosthetic heart valve (PHV) implantation procedures have been performed in sequence with the aging of the population and improving surgical techniques. Currently, echocardiography is the most important tool in the follow-up and evaluation of complications associated with the PHV (pannus, thrombus, endocarditis). However, echocardiographic examination of PHV associated disease may be hampered by poor acoustic window or scatter artefacts caused by the PHV. PHV related disease such as endocarditis is related with a poor prognosis, especially when complications such as periannular abcess formation occurs. Early treatment of PHV associated disease improves prognosis. Therefore, an unmet clinical need for early detection of complications exists. In the evaluation of PHV (dys)function, multidetector-row computed tomography (MDCT) has shown to be of additive value. A necessity for MDCT to be implemented in daily practice is to be able to distinguish between normal and pathological features. Key Points • Early detection of PHV related complications improves prognosis • MDCT has additive value to echocardiography in the evaluation of PHV • RCTs for MDCT evaluation of PHV are required for clinical implementation.
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Affiliation(s)
- F E C M Peeters
- Department of Cardiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
| | - B L J H Kietselaer
- Department of Cardiology, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. .,Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
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Chaikriangkrai K, Choi SY, Nabi F, Chang SM. Important advances in technology and unique applications to cardiovascular computed tomography. Methodist Debakey Cardiovasc J 2015; 10:152-8. [PMID: 25574342 DOI: 10.14797/mdcj-10-3-152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
For the past decade, multidetector cardiac computed tomography and its main application, coronary computed tomography angiography, have been established as a noninvasive technique for anatomical assessment of coronary arteries. This new era of coronary artery evaluation by coronary computed tomography angiography has arisen from the rapid advancement in computed tomography technology, which has led to massive diagnostic and prognostic clinical studies in various patient populations. This article gives a brief overview of current multidetector cardiac computed tomography systems, developing cardiac computed tomography technologies in both hardware and software fields, innovative radiation exposure reduction measures, multidetector cardiac computed tomography functional studies, and their newer clinical applications beyond coronary computed tomography angiography.
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Affiliation(s)
| | - Su Yeon Choi
- Seoul National University Hospital, Seoul, South Korea
| | - Faisal Nabi
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas
| | - Su Min Chang
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas
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Suchá D, Symersky P, Tanis W, Mali WP, Leiner T, van Herwerden LA, Budde RP. Multimodality Imaging Assessment of Prosthetic Heart Valves. Circ Cardiovasc Imaging 2015; 8:e003703. [DOI: 10.1161/circimaging.115.003703] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Echocardiography and fluoroscopy are the main techniques for prosthetic heart valve (PHV) evaluation, but because of specific limitations they may not identify the morphological substrate or the extent of PHV pathology. Cardiac computed tomography (CT) and magnetic resonance imaging (MRI) have emerged as new potential imaging modalities for valve prostheses. We present an overview of the possibilities and pitfalls of CT and MRI for PHV assessment based on a systematic literature review of all experimental and patient studies. For this, a comprehensive systematic search was performed in PubMed and Embase on March 24, 2015, containing CT/MRI and PHV synonyms. Our final selection yielded 82 articles on surgical valves. CT allowed adequate assessment of most modern PHVs and complemented echocardiography in detecting the obstruction cause (pannus or thrombus), bioprosthesis calcifications, and endocarditis extent (valve dehiscence and pseudoaneurysms). No clear advantage over echocardiography was found for the detection of vegetations or periprosthetic regurgitation. Whereas MRI metal artifacts may preclude direct prosthesis analysis, MRI provided information on PHV-related flow patterns and velocities. MRI demonstrated abnormal asymmetrical flow patterns in PHV obstruction and allowed prosthetic regurgitation assessment. Hence, CT shows great clinical relevance as a complementary imaging tool for the diagnostic work-up of patients with suspected PHV obstruction and endocarditis. MRI shows potential for functional PHV assessment although more studies are required to provide diagnostic reference values to allow discrimination of normal from pathological conditions.
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Affiliation(s)
- Dominika Suchá
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
| | - Petr Symersky
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
| | - W. Tanis
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
| | - Willem P.Th.M. Mali
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
| | - Tim Leiner
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
| | - Lex A. van Herwerden
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
| | - Ricardo P.J. Budde
- From the Departments of Radiology (D.S., W.P.Th.M.M., T.L., R.P.J.B.) and Cardiothoracic Surgery (L.A.v.H.), University Medical Center Utrecht, Utrecht, The Netherlands; Department of Cardiothoracic Surgery, VU University Medical Center, Amsterdam, The Netherlands (P.S.); Department of Cardiology, HagaZiekenhuis, The Hague, The Netherlands (W.T.); and Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands (R.P.J.B.)
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Han K, Yang DH, Shin SY, Kim N, Kang JW, Kim DH, Song JM, Kang DH, Song JK, Kim JB, Jung SH, Choo SJ, Chung CH, Lee JW, Lim TH. Subprosthetic Pannus after Aortic Valve Replacement Surgery: Cardiac CT Findings and Clinical Features. Radiology 2015; 276:724-31. [DOI: 10.1148/radiol.2015142400] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Suh YJ, Kim YJ, Hong YJ, Lee HJ, Hur J, Im DJ, Kim YJ, Choi BW. Measurement of Opening and Closing Angles of Aortic Valve Prostheses In Vivo Using Dual-Source Computed Tomography: Comparison with Those of Manufacturers' in 10 Different Types. Korean J Radiol 2015; 16:1012-23. [PMID: 26356549 PMCID: PMC4559772 DOI: 10.3348/kjr.2015.16.5.1012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 06/26/2015] [Indexed: 11/15/2022] Open
Abstract
Objective The aims of this study were to compare opening and closing angles of normally functioning mechanical aortic valves measured on dual-source computed tomography (CT) with the manufacturers' values and to compare CT-measured opening angles according to valve function. Materials and Methods A total of 140 patients with 10 different types of mechanical aortic valves, who underwent dual-source cardiac CT, were included. Opening and closing angles were measured on CT images. Agreement between angles in normally functioning valves and the manufacturer values was assessed using the interclass coefficient and the Bland-Altman method. CT-measured opening angles were compared between normal functioning valves and suspected dysfunctioning valves. Results The CT-measured opening angles of normally functioning valves and manufacturers' values showed excellent agreement for seven valve types (intraclass coefficient [ICC], 0.977; 95% confidence interval [CI], 0.962-0.987). The mean differences in opening angles between the CT measurements and the manufacturers' values were 1.2° in seven types of valves, 11.0° in On-X valves, and 15.5° in ATS valves. The manufacturers' closing angles and those measured by CT showed excellent agreement for all valve types (ICC, 0.953; 95% CI, 0.920-0.972). Among valves with suspected dysfunction, those with limitation of motion (LOM) and an increased pressure gradient (PG) had smaller opening angles than those with LOM only (p < 0.05). Conclusion Dual-source cardiac CT accurately measures opening and closing angles in most types of mechanical aortic valves, compared with the manufacturers' values. Opening angles on CT differ according to the type of valve dysfunction and a decreased opening angle may suggest an elevated PG.
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Affiliation(s)
- Young Joo Suh
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Young Jin Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yoo Jin Hong
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Hye-Jeong Lee
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jin Hur
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Dong Jin Im
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Yun Jung Kim
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Byoung Wook Choi
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
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Suh YJ, Kim YJ, Lee S, Hong YJ, Lee HJ, Hur J, Choi BW, Chang BC. Utility of cardiac computed tomography for evaluation of pannus in mechanical aortic valve. Int J Cardiovasc Imaging 2015; 31:1271-80. [DOI: 10.1007/s10554-015-0683-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 05/15/2015] [Indexed: 10/23/2022]
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CT of Cardiac Valves. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Leetmaa T, Hansson NC, Leipsic J, Jensen K, Poulsen SH, Andersen HR, Jensen JM, Webb J, Blanke P, Tang M, Nørgaard BL. Early Aortic Transcatheter Heart Valve Thrombosis. Circ Cardiovasc Interv 2015; 8:CIRCINTERVENTIONS.114.001596. [DOI: 10.1161/circinterventions.114.001596] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Early stent valve thrombosis after transcatheter aortic valve implantation (TAVI) is a rare complication, which is diagnosed based on the appearance of clinical symptoms of heart failure and echocardiographic findings. After TAVI, transthoracic echocardiography is performed to assess transcatheter heart valve (THV) function. However, preliminary reports indicate the potential additive clinical value of multidetector computed tomography (MDCT) for the diagnosis of THV thrombosis. We sought to determine the value of MDCT for the diagnosis of THV thrombosis and the frequency of this complication after balloon-expandable TAVI.
Methods and Results—
MDCT was performed in 140 patients within 1 to 3 months after TAVI with the Edwards Sapien XT THV to assess the presence of THV thrombosis and THV stent geometry. Post-TAVI MDCT identified THV thrombosis in 5 patients (4%). Of note, 4 of these patients were asymptomatic and had a normal transthoracic echocardiographic examination without signs of thrombus formation or flow obstruction. In patients with THV thrombosis, a left ventricular ejection fraction of <35% was present in 3 (60%), whereas 2 (40%) did not receive standard post-TAVI dual-antiplatelet therapy. Neither THV underexpansion nor THV noncircularity was detected in patients with THV thrombosis.
Conclusions—
Post-TAVI MDCT is a valuable tool for the diagnosis of THV thrombosis, and this complication seems to be more common than previously anticipated. Larger studies are required to identify specific risk factors of THV thrombosis.
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Affiliation(s)
- Tina Leetmaa
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Nicolaj C. Hansson
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Jonathon Leipsic
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Kaare Jensen
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Steen H. Poulsen
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Henning R. Andersen
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Jesper M. Jensen
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - John Webb
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Philipp Blanke
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Mariann Tang
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
| | - Bjarne L. Nørgaard
- From the Department of Cardiology (T.L., N.C.H., K.J., S.H.P., H.R.A., J.M.J., B.L.N.), Department of Cardiothoracic and Vascular Surgery (M.T.), Aarhus University Hospital Skejby, Aarhus, Denmark; and Division of Cardiology and Department of Radiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (J.L., J.W., P.B.)
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Kim YJ, Yong HS, Kim SM, Kim JA, Yang DH, Hong YJ. Korean guidelines for the appropriate use of cardiac CT. Korean J Radiol 2015; 16:251-85. [PMID: 25741189 PMCID: PMC4347263 DOI: 10.3348/kjr.2015.16.2.251] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 01/03/2015] [Indexed: 01/07/2023] Open
Abstract
The development of cardiac CT has provided a non-invasive alternative to echocardiography, exercise electrocardiogram, and invasive angiography and cardiac CT continues to develop at an exponential speed even now. The appropriate use of cardiac CT may lead to improvements in the medical performances of physicians and can reduce medical costs which eventually contribute to better public health. However, until now, there has been no guideline regarding the appropriate use of cardiac CT in Korea. We intend to provide guidelines for the appropriate use of cardiac CT in heart diseases based on scientific data. The purpose of this guideline is to assist clinicians and other health professionals in the use of cardiac CT for diagnosis and treatment of heart diseases, especially in patients at high risk or suspected of heart disease.
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Affiliation(s)
- Young Jin Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Hwan Seok Yong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea
| | - Sung Mok Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea
| | - Jeong A Kim
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706, Korea
| | - Dong Hyun Yang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Yoo Jin Hong
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea
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Emerging Role of Cardiovascular CT and MRI in the Evaluation of Stroke. AJR Am J Roentgenol 2015; 204:269-80. [DOI: 10.2214/ajr.14.13051] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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50
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Salgado RA, Budde RPJ, Leiner T, Shivalkar B, Van Herck PL, Op de Beeck BJ, Vrints C, Buijsrogge MP, Stella PR, Rodrigus I, Bosmans J, Parizel PM. Transcatheter Aortic Valve Replacement: Postoperative CT Findings of Sapien and CoreValve Transcatheter Heart Valves. Radiographics 2014; 34:1517-36. [DOI: 10.1148/rg.346130149] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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