Key result
CT angiography provides incremental diagnostic information for evaluating prosthetic heart valve dysfunction, obstruction, and endocarditis when first-line imaging is inconclusive.
Why the study?
Prosthetic heart valve dysfunction is potentially life-threatening, and when first-line echocardiography and cinefluoroscopy findings are inconclusive or contradictory, CT angiography can resolve conflicts and provide incremental diagnostic information.
CT angiography is a valuable multimodality imaging tool for diagnosing and guiding clinical management of prosthetic heart valve complications when first-line imaging is inconclusive.
Answers are grounded in this paper and cite their sources.
May support CT angiography when first-line imaging is inconclusive for prosthetic valves; leaves open need for prospective validation.
Prosthetic heart valve (PHV) dysfunction is an uncommon but potentially life-threatening condition. In routine practice, transthoracic echocardiography and cinefluoroscopy comprise first-line imaging for the diagnostic evaluation of PHV dysfunction. In cases in which the findings of echocardiography and cinefluoroscopy remain inconclusive or are contradictory, CT angiography can resolve these conflicts. CT angiography also provides incremental diagnostic information about patients with suspected PHV obstruction and endocarditis, in which case it can demonstrate the anatomic substrate and extent of involvement. Additionally, information regarding the coronary arteries, cardiac dimensions, and retrosternal space may be obtained in cases in which repeat surgery is planned. This imaging essay describes the imaging spectrum of valvular and paravalvular complications of PHV at CT angiography and how the knowledge regarding the spectrum of complications can be incorporated into multimodality imaging for guiding clinical management. Keywords: Prosthetic Heart Valve Dysfunction, Prosthetic Heart Valve Thrombosis, Pannus, Paravalvular Leak, CT Angiography, Cardiac, Valves Supplemental material is available for this article.
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Verma et al. (2021) conducted a review in Prosthetic Heart Valve Dysfunction. CT Angiography was evaluated. CT angiography provides incremental diagnostic information for evaluating prosthetic heart valve dysfunction, obstruction, and endocarditis when first-line imaging is inconclusive.
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