| Title | The role of ECG-gated MDCT in the evaluation of aortic and mitral mechanical valves: initial experience. | | Author(s) | Konen E, Goitein O, Feinberg MS, Eshet Y, Raanani E, Rimon U, Di-Segni E | | Institution | Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel. eli.konen@sheba.health.gov.il | | Source | AJR Am J Roentgenol 2008 Jul; 191(1):26-31. | | MeSH | Adult
Aged
Aortic Valve
Electrocardiography
Equipment Failure Analysis
Female
Heart Valve Prosthesis
Humans
Male
Middle Aged
Mitral Valve
Pilot Projects
Radiographic Image Enhancement
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed
| | Abstract | 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. | | Language | eng | | Pub Type(s) | Evaluation Studies
Journal Article
| | PubMed ID | 18562720 |
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