title: Diagnostic evaluation of left-sided prosthetic heart valve dysfunction.
abstract: Prosthetic heart valve (PHV) dysfunction is a rare, but potentially life-threatening, complication. In clinical practice, PHV dysfunction poses a diagnostic dilemma. Echocardiography and fluoroscopy are the imaging techniques of choice and are routinely used in daily practice. However, these techniques sometimes fail to determine the specific cause of PHV dysfunction, which is crucial to the selection of the appropriate treatment strategy. Multidetector-row CT (MDCT) can be of additional value in diagnosing the specific cause of PHV dysfunction and provides valuable complimentary information for surgical planning in case of reoperation. Cardiac magnetic resonance imaging (CMR) has limited value in the evaluation of biological PHV dysfunction. In this Review, we discuss the use of established imaging modalities for the detection of left-sided mechanical and biological PHV dysfunction and discuss the complementary role of MDCT in this context.
authors.affiliation: Department of Radiology, University Medical Center, Utrecht, P. O. Box 85500, 3508 GA, The Netherlands. j.habets@ umcutrecht.nl
authors.forename: Jesse
authors.initials: J
authors.lastname: Habets
authors.forename: Ricardo P
authors.initials: RP
authors.lastname: Budde
authors.forename: Petr
authors.initials: P
authors.lastname: Symersky
authors.forename: Renee B
authors.initials: RB
authors.lastname: van den Brink
authors.forename: Bas A
authors.initials: BA
authors.lastname: de Mol
authors.forename: Willem P
authors.initials: WP
authors.lastname: Mali
authors.forename: Lex A
authors.initials: LA
authors.lastname: van Herwerden
authors.forename: Steven A
authors.initials: SA
authors.lastname: Chamuleau
mesh_terms: D003952:Diagnostic Imaging / Q000379:methods; D004452:Echocardiography; D005471:Fluoroscopy; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed