title: Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard.
abstract: The purpose was to compare the findings of multi-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiography (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) and pseudoaneurysm formation. Patients indicated for surgery received an operation within 1 week. The MDCT findings were compared with the operative findings. One patient with a Björk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCT was 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCT or TTE. Six patients received an operation that included three redo aortic valve replacements, two redo mitral replacements and one Amplatzer ductal occluder occlusion of a mitral paravalvular leak. The concordance of MDCT for diagnosing and localizing prosthetic valve disorders and the surgical findings was 100%. Except for images impaired by severe beam-hardening artifacts, MDCT provides excellent delineation of prosthetic valve disorders.
authors.affiliation: Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China. sillyduck.radiology@gmail.com
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Tsai
authors.forename: Yung-Kai
authors.initials: YK
authors.lastname: Lin
authors.forename: Yen
authors.initials: Y
authors.lastname: Chang
authors.forename: Yun-Ching
authors.initials: YC
authors.lastname: Fu
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Shih-Rong
authors.initials: SR
authors.lastname: Hsieh
authors.forename: Hao-Ji
authors.initials: HJ
authors.lastname: Wei
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Tsai
authors.forename: Sheng-Ling
authors.initials: SL
authors.lastname: Jan
authors.forename: Kuo-Yang
authors.initials: KY
authors.lastname: Wang
authors.forename: Min-Chi
authors.initials: MC
authors.lastname: Chen
authors.forename: Clayton Chi-Chang
authors.initials: CC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography / Q000379:methods; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design / Q000379:methods; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed / Q000379:methods*