Key result
ECG-gated MDCT clearly demonstrated calcified bioprosthetic cusps with reduced mobility and allowed direct planimetry of the valve orifice area in a patient with structural valve deterioration.
Case Report (n=1)
No
ECG-gated MDCT is a feasible and effective imaging modality for diagnosing structural valve deterioration and measuring valve orifice area in bioprosthetic aortic valves when echocardiography is limited by artifacts.
May support MDCT assessment when echocardiography is limited; leaves open routine use pending larger validation studies.
A 32-year-old female patient presented with shortness of breath. The patient had received aortic valve replacement with a 25-mm bioprosthetic valve at the age of 22, and had had two babies, postoperatively. Ten years later, echocardiography showed the calcifi ed bioprosthetic valve with a high peak pressure gradient (70 mmHg) and a reduced valve orifice area (0.46 cm(2)). Electrocardiographically gated multidetector row computed tomography (ECG-gated MDCT) clearly demonstrated calcifi ed bioprosthetic cusps with reduced mobility, and the valve orifi ce area was measured to be 0.64 cm(2) by direct planimetry. These fi ndings observed by ECG-gated MDCT were confi rmed at reoperation. This is the fi rst reported reoperation case of aortic structural valve deterioration clearly visualized by ECG-gated MDCT.
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Teshima et al. (2013) conducted a case report in Structural valve deterioration of aortic bioprosthetic valve (n=1). Electrocardiographically gated multidetector row computed tomography (ECG-gated MDCT) vs. Transthoracic echocardiography (TTE) was evaluated on Visualization of structural valve deterioration. ECG-gated MDCT clearly demonstrated calcified bioprosthetic cusps with reduced mobility and allowed direct planimetry of the valve orifice area in a patient with structural valve deterioration.
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