Abstract
ECG-gated multidetector computed tomography (MDCT) is a promising complementary technique for evaluation of cardiac native and prosthetic structures. MDCT is able to provide a broader coverage with faster scan acquisition times that yield higher spatial and temporal resolution for cardiac structures whose quality may be affected by artifacts on ultrasound. We report a case series about the most challenging complications occurring after prosthetic aortic valve implantation in four patients: pannus, paravalvular leak, prosthesis’ misfolding and subaortic membrane reformation. In all the cases, enhanced MDCT using a retrospective protocol provided accurate 3D morphoanatomic information about cardiac and extracardiac structures, improving and speeding up the correct diagnosis and treatment planning. Integrated imaging, in particular with MDCT, is now the present, and it will increasingly be the future in the assessment of cardiac structural pathology.
Highlights
De Conti, G.; Barbiero, G.; Mele, D.; Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy; Abstract: ECG-gated multidetector computed tomography (MDCT) is a promising complementary technique for evaluation of cardiac native and prosthetic structures
Cardiac computed tomography (CCT) is generally employed when other imaging modalities fail to reach a definite diagnosis of valve dysfunction [1]
Multidetector and dual-source scanners are able to provide a broader coverage with faster scan acquisition times that yield higher spatial and temporal resolution for cardiac structures
Summary
Transthoracic (TTE) and transesophageal echocardiography (TEE) represent the primary noninvasive tests in the follow-up of patients with prosthetic valve diseases. In addition to its powerful diagnostic accuracy in coronary artery disease, a growing indication of MDCT is the assessment of native and prosthetic heart valves (PHVs). In the latter case, several artifacts, such as mechanical acoustic shadowing, reverberations, refraction and mirroring, may develop, affecting the imaging quality on ultrasound (US) [2,3,4]. We report a case series about the role of MDCT in PHV dysfunction importance of multimodality imaging (echocardiography integrated with MDCT) to ensure correct diagnosis and treatment.
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