Diagnostic accuracy of cardiac computed tomographic angiography and transesophageal echocardiography in evaluation of patients with prosthetic paravalvular leakage

Amr Youssef Hassan; Hossam Kandil; Mohamed A. Salem; Ahmed Shehata Mohamed; Hussien Heshmat Kassem

doi:10.1111/echo.15428

July 24, 2022Echocardiography

Diagnostic accuracy of cardiac computed tomographic angiography and transesophageal echocardiography in evaluation of patients with prosthetic paravalvular leakage

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Why the study?

The role of CT in assessing patients with prosthetic paravalvular leakage had not been studied thoroughly.

Does 64-slice ECG-gated CT provide comparable diagnostic accuracy to TEE and intraoperative findings in evaluating patients with suspected prosthetic paravalvular leakage?

Key Points

To evaluate the feasibility, reproducibility, and diagnostic accuracy of cardiac computed tomography for detecting and assessing prosthetic paravalvular leakage compared with surgical reference findings.
Prospective cohort study involving 26 consecutive patients with suspected prosthetic paravalvular leakage.
Participants underwent both transesophageal echocardiography and 64-slice ECG-gated cardiac computed tomography, with intraoperative findings during subsequent surgery serving as the reference gold standard (N=26).
Cardiac CT demonstrated an excellent degree of agreement with surgical findings for both the diagnosis and anatomical localization of prosthetic paravalvular leakage.
Paravalvular leakage perimeter measured by CT correlated strongly with echocardiographic severity assessed by transesophageal echocardiography (Spearman's r = 0.83, p = 0.0014).

Structured PICO

Does 64-slice ECG-gated CT provide comparable diagnostic accuracy to TEE and intraoperative findings in evaluating patients with suspected prosthetic paravalvular leakage?

P

Population

26 consecutive patients with suspected prosthetic paravalvular leakage (PVL) who underwent surgery

I

Intervention

64-slice ECG-gated Computed Tomography (CT)

C

Comparator

Transesophageal echocardiography (TEE) with intraoperative findings as the reference standard

O

Outcome

Diagnostic accuracy for detection, localization, and assessment of severity of prosthetic PVLsurrogate

Cardiac CT demonstrates excellent diagnostic accuracy and correlation with TEE and surgical findings for evaluating prosthetic paravalvular leakage.

Implication

Supports cardiac CT as a complementary tool for grading paravalvular leak severity; extends structural imaging.

Discussion

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Cite This Study

Hassan et al. (2022) studied this question.

synapsesocial.com/papers/6a8d58d9744d533c407dc9d3 https://doi.org/10.1111/echo.15428

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Diagnostic accuracy of cardiac computed tomographic angiography and transesophageal echocardiography in evaluation of patients with prosthetic paravalvular leakage

Key Points

Structured PICO

Implication

Discussion

Cite This Study

Diagnostic accuracy of cardiac computed tomographic angiography and transesophageal echocardiography in evaluation of patients with prosthetic paravalvular leakage

Key Points

Structured PICO

Implication

Discussion

Cite This Study

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