title: Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valves.
abstract: OBJECTIVE
  Patients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT.
  
  
  METHODS
  ECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of prosthetic heart valves. The best systolic and diastolic axial reconstructions were selected for coronary assessment. Each present coronary segment was scored for the presence of valve-related artefacts prohibiting coronary artery assessment. Scoring was performed in consensus by two observers.
  
  
  RESULTS
  Eighty-two CT angiograms were performed on a 64-slice (n = 27) or 256-slice (n = 55) multidetector CT. Eighty-nine valves and five annuloplasty rings were present. Forty-three out of 1160 (3.7%) present coronary artery segments were non-diagnostic due to valve artefacts (14/82 patients). Valve artefacts were located in right coronary artery (15/43; 35%), left anterior descending artery (2/43; 5%), circumflex artery (14/43; 32%) and marginal obtuse (12/43; 28%) segments. All cobalt-chrome containing valves caused artefacts prohibiting coronary assessment. Biological and titanium-containing valves did not cause artefacts except for three specific valve types.
  
  
  CONCLUSIONS
  Most commonly implanted prosthetic heart valves do not hamper coronary assessment on multidetector CT. Cobalt-chrome containing prosthetic heart valves preclude complete coronary artery assessment because of severe valve artefacts.
  
  
  CONCLUSIONS
  • Most commonly implanted prosthetic heart valves do not hamper coronary artery assessment • Prosthetic heart valve composition determines the occurrence of prosthetic heart valve-related artefacts • Björk-Shiley and Sorin tilting disc valves preclude diagnostic coronary artery segment assessment.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E01.132, PO BOX 85500, 3508 GA Utrecht, The Netherlands. J.Habets@umcutrecht.nl
authors.forename: Jesse
authors.initials: J
authors.lastname: Habets
authors.forename: Renee B A
authors.initials: RB
authors.lastname: van den Brink
authors.forename: Ruben
authors.initials: R
authors.lastname: Uijlings
authors.forename: Anje M
authors.initials: AM
authors.lastname: Spijkerboer
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.forename: Steven A J
authors.initials: SA
authors.lastname: Chamuleau
authors.forename: Ricardo P J
authors.initials: RP
authors.lastname: Budde
mesh_terms: D016477:Artifacts; D055424:Cardiac-Gated Imaging Techniques / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006350:Heart Valve Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*