title: Baseline MDCT findings after prosthetic heart valve implantation provide important complementary information to echocardiography for follow-up purposes.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  • 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.
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands. d.sucha@umcutrecht.nl.
authors.forename: Dominika
authors.initials: D
authors.lastname: Suchá
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Steven A J
authors.initials: SA
authors.lastname: Chamuleau
authors.affiliation: Department of Cardiothoracic Surgery, VU Medical Center, Amsterdam, The Netherlands.
authors.forename: Petr
authors.initials: P
authors.lastname: Symersky
authors.affiliation: Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Matthijs F L
authors.initials: MF
authors.lastname: Meijs
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Renee B A
authors.initials: RB
authors.lastname: van den Brink
authors.affiliation: Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Bas A J M
authors.initials: BA
authors.lastname: de Mol
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Huispostnummer E01.132, Heidelberglaan 100, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: Jesse
authors.initials: J
authors.lastname: Habets
authors.affiliation: Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Lex A
authors.initials: LA
authors.lastname: van Herwerden
authors.affiliation: 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.
authors.forename: Ricardo P J
authors.initials: RP
authors.lastname: Budde
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011475:Prosthesis Failure / Q000009:adverse effects*; D012008:Recurrence; D012015:Reference Standards
keywords: Diagnostic imaging; Echocardiography; Heart valve prosthesis; Multidetector-row computed tomography; Reference standard