OBJECTIVE: The objective of our study was to evaluate the role of ECG-gated MDCT in the functional evaluation of mechanical prosthetic aortic and mitral valves. MATERIALS AND METHODS: Twenty sequential patients with 23 mechanical prosthetic valves were evaluated with an ECG-gated 40- or 64-MDCT scanner. Multiplanar reformation, maximal-intensity-projection, volume-rendering, and volume-averaging techniques were used for visualization of valve leaflets in systole and diastole. The visibility of each mechanical valve was evaluated by consensus of a radiologist and a cardiologist using a subjective 5-point scale (0-4). MDCT findings were correlated with fluoroscopic opening and closing angle measurements and echocardiographic pressure gradient measurements in 11 and 19 valves, respectively. RESULTS: The series included 18 bileaflet and five single-leaflet mechanical valves. The visibility score for the bileaflet mechanical valves was excellent (score of 4) in all 18 cases, but it was lower for single-leaflet valves (mean score, 2.8; range, 1-4) (p = 0.04). Bland-Altman plots showed high agreement between MDCT and fluoroscopy for measurements of opening and closing angles of bileaflet mechanical valves. In four patients, a stuck valve was seen on MDCT and was confirmed by fluoroscopy. Doppler echocardiography showed increased transvalvular pressure in two of the four patients with a stuck mitral valve and increased transaortic pressure in four patients with normal prosthetic aortic valve motion. CONCLUSION: Our preliminary results suggest that MDCT is a promising technique for functional evaluation of bileaflet mechanical valves, allowing reliable measurements of opening and closing leaflet angles. However, the role of MDCT in the evaluation of single-leaflet valves might be limited.
OBJECTIVE: The objective of our study was to evaluate the role of ECG-gated MDCT in the functional evaluation of mechanical prosthetic aortic and mitral valves. MATERIALS AND METHODS: Twenty sequential patients with 23 mechanical prosthetic valves were evaluated with an ECG-gated 40- or 64-MDCT scanner. Multiplanar reformation, maximal-intensity-projection, volume-rendering, and volume-averaging techniques were used for visualization of valve leaflets in systole and diastole. The visibility of each mechanical valve was evaluated by consensus of a radiologist and a cardiologist using a subjective 5-point scale (0-4). MDCT findings were correlated with fluoroscopic opening and closing angle measurements and echocardiographic pressure gradient measurements in 11 and 19 valves, respectively. RESULTS: The series included 18 bileaflet and five single-leaflet mechanical valves. The visibility score for the bileaflet mechanical valves was excellent (score of 4) in all 18 cases, but it was lower for single-leaflet valves (mean score, 2.8; range, 1-4) (p = 0.04). Bland-Altman plots showed high agreement between MDCT and fluoroscopy for measurements of opening and closing angles of bileaflet mechanical valves. In four patients, a stuck valve was seen on MDCT and was confirmed by fluoroscopy. Doppler echocardiography showed increased transvalvular pressure in two of the four patients with a stuck mitral valve and increased transaortic pressure in four patients with normal prosthetic aortic valve motion. CONCLUSION: Our preliminary results suggest that MDCT is a promising technique for functional evaluation of bileaflet mechanical valves, allowing reliable measurements of opening and closing leaflet angles. However, the role of MDCT in the evaluation of single-leaflet valves might be limited.
Authors: Young Joo Suh; Young Jin Kim; Yoo Jin Hong; Hye-Jeong Lee; Jin Hur; Sae Rom Hong; Dong Jin Im; Yun Jung Kim; Byoung Wook Choi Journal: Int J Cardiovasc Imaging Date: 2015-12-01 Impact factor: 2.357
Authors: Monvadi B Srichai; Hersh Chandarana; Robert Donnino; Irene Isabel P Lim; Christianne Leidecker; James Babb; Jill E Jacobs Journal: World J Radiol Date: 2013-08-28
Authors: Linda M de Heer; Jesse Habets; Jolanda Kluin; Pieter R Stella; Willem P Th M Mali; Lex A van Herwerden; Ricardo P J Budde Journal: Int J Cardiovasc Imaging Date: 2012-08-09 Impact factor: 2.357
Authors: Jesse Habets; Ricardo P Budde; Petr Symersky; Renee B van den Brink; Bas A de Mol; Willem P Mali; Lex A van Herwerden; Steven A Chamuleau Journal: Nat Rev Cardiol Date: 2011-05-17 Impact factor: 32.419
Authors: Jesse Habets; Petr Symersky; Tim Leiner; Bas A J M de Mol; Willem P Th M Mali; Ricardo P J Budde Journal: Int J Cardiovasc Imaging Date: 2012-04-05 Impact factor: 2.357
Authors: Jesse Habets; Renee B A van den Brink; Ruben Uijlings; Anje M Spijkerboer; Willem P Th M Mali; Steven A J Chamuleau; Ricardo P J Budde Journal: Eur Radiol Date: 2011-12-23 Impact factor: 5.315