Challenging Cases of Aortic Prosthesis Dysfunction, the Importance of Multimodality Imaging, a Case Series

Figures

• 

  Figure 1. MPR of a St. Jude PHV (10% of the RR interval): long-axis view showing the maximum opening angle of the anterior and posterior leaflets, 55.7° and 63.9° (normal range, 75–90°), respectively (a); region of interest (ROI) on the periprosthetic hypodense tissue (b); 3D anatomical model of the PHV involved by the pannus (c).

• 

  Figure 2. Long-axis (a) and short-axis (b) MPR focusing on the subaortic membrane (arrow) located 7 mm below the aortic annulus, with the maximum thickness of 5 mm and hemicircumferential extension along the interventricular septal surface.

• 

  Figure 3. MPR of the aortic annulus to better analyze the pseudoaneurysm (arrows) and its relations with contiguous structures. Long-axis (a,b) and short-axis views (c) of the peri-prosthesis abscess with discontinuous longitudinal extension for 4 cm communicating with LVOT through a 5 mm window.

• 

  Figure 4. Oblique MPR (a), axial (b) and 3D anatomical model (c) of transcatheter PHV (LOTUS Edge 27 mm) focusing on its frame’s partial crumpling (arrow). A cluster of calcifications can be noted under the PHV.