MDCT clearly visualized subprosthetic pannus causing prosthetic valve obstruction, with the mean CT attenuation of pannus (170 HU) being significantly higher than that of the interventricular septum (108 HU, P<0.0001).
Observational (n=9)
No
Does electrocardiographically gated MDCT accurately visualize and characterize the cause of prosthetic valve obstruction in patients with aortic bileaflet mechanical valves?
ECG-gated MDCT can effectively visualize subprosthetic pannus causing aortic prosthetic valve obstruction and characterize it using CT attenuation.
Absolute Event Rate: 170% vs 108%
p-value: p=<0.0001
BACKGROUND: This study was performed to evaluate the diagnostic role of electrocardiographically gated multidetector-row computed tomography (MDCT) for prosthetic valve obstruction (PVO) in the aortic position. METHODS AND RESULTS: Between 2002 and 2006, 9 patients were diagnosed with PVO of an aortic bileaflet mechanical valve based on echocardiographic and cineradiographic criteria. These 9 patients were examined using MDCT before replacement of the mechanical valve, and intraoperative findings were compared to morphologic periprosthetic abnormalities observed on MDCT. CT attenuation (Hounsfield units; HU) of the periprosthetic abnormalities was measured to investigate the underlying cause of the PVO. MDCT showed subprosthetic masses extending beyond the prosthetic ring into the orifice of the valve. At reoperation, presence of subprosthetic pannus was confirmed in all of the 9 patients, but no periprosthetic thrombus was found. The mean CT attenuation of the subprosthetic pannus was 170 HU, and it was significantly greater than that obtained from the interventricular septum (108 HU; P<0.0001). CONCLUSIONS: MDCT can be used to clearly visualize subprosthetic pannus causing PVO and the mean CT attenuation of subprosthetic pannus is significantly higher than that of the interventricular septum on MDCT.
Ueda et al. (Wed,) conducted a observational in Prosthetic valve obstruction (n=9). Multidetector-row computed tomography (MDCT) vs. Interventricular septum (internal control for CT attenuation) was evaluated on Mean CT attenuation (Hounsfield units) (p=<0.0001). MDCT clearly visualized subprosthetic pannus causing prosthetic valve obstruction, with the mean CT attenuation of pannus (170 HU) being significantly higher than that of the interventricular septum (108 HU, P<0.0001).
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