Valvular heart diseaseComparison of Multidetector-Row Computed Tomography to Echocardiography and Fluoroscopy for Evaluation of Patients With Mechanical Prosthetic Valve Obstruction
Section snippets
Methods
In this retrospective study we included 13 consecutive patients with 15 mechanical prosthetic valves who had undergone cardiac multidetector-row computed tomographic (MDCT) scanning from January 2005 to August 2008 and in whom PVO of unknown cause was present. During the study period, 6 patients presented with evident thrombotic obstruction or hemodynamic instability and were not included. Reasons for MDCT scanning were suspected coronary disease, evaluation of suspected aortic root pathology,
Results
Thirteen patients (6 men, age 35 to 84 years) underwent MDCT scanning. Fifteen mechanical prosthetic valves were present. The group included 10 patients with isolated aortic valves, 2 patients with aortic and mitral valves, and 1 patient with a mitral prosthesis. One of the 2 patients with aortic and mitral prostheses had obstruction of the 2 valves (patient 12). In total 14 of 15 valves were obstructed. Patient characteristics are presented in Table 1.
Presence of important periprosthetic leaks
Discussion
Our study, which describes our initial experience with multidetector-row computed tomography, shows that purely morphologic differentiation provided valuable additional findings in 8 of 13 patients with PVO. These additional findings constituted indications for surgery in 8 patients. Importantly, multidetector-row computed tomography could directly visualize subprosthetic tissue proliferation in 6 patients, which is notoriously difficult to detect by other techniques.13, 14 These findings were
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