Key result
Gated MDCT shows promise for detecting or excluding pannus in mechanical heart valves.
Why the study?
Pannus formation may not be diagnosed with 2-dimensional transesophageal echocardiography in patients with mechanical heart valves and elevated transprosthetic gradients without leaflet immobility, necessitating alternative imaging methods.
Does electrocardiographically gated 64-section MDCT improve the diagnosis of pannus formation in patients with mechanical heart valves compared to 2-dimensional transesophageal echocardiography?
Case Report
Does electrocardiographically gated 64-section MDCT improve the diagnosis of pannus formation in patients with mechanical heart valves compared to 2-dimensional transesophageal echocardiography?
MDCT is a useful imaging modality for differentiating pannus formation from patient-prosthesis mismatch in patients with mechanical heart valves and elevated gradients.
May support MDCT for suspected pannus when TEE is inconclusive; leaves open need for prospective validation.
Patient-prosthesis mismatch (PPM) should be recognized in patients with elevated transprosthetic gradients but without leaflet immobility, since the treatment strategy may differ in either etiology. However, thrombus and/or pannus formation should be excluded before a diagnosis of PPM is made. Particularly, pannus formation may not be diagnosed with 2-dimensional transesophageal echocardiography. Electrocardiographically gated 64-section multidetector computed tomography (MDCT) may be a promising tool in diagnosing or excluding pannus formation. Our report underlines the utility of MDCT in this regard and also emphasizes the importance of recognition of PPM as a differential diagnosis in such patients.
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Sabahattin Gündüz (2015) conducted a case report in Mechanical heart valves with elevated transprosthetic gradients. Electrocardiographically gated 64-section multidetector computed tomography (MDCT) vs. 2-dimensional transesophageal echocardiography was evaluated on Diagnosis or exclusion of pannus formation. Electrocardiographically gated 64-section multidetector computed tomography (MDCT) is a promising tool for diagnosing or excluding pannus formation in patients with mechanical heart valves.
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