Cardiac CT in prosthetic aortic valve complications

Abstract

In the current era of transcatheter device therapy, the prevalence of prosthetic aortic valves and their associated complications is increasing. Echocardiography remains the first-line imaging investigation for the assessment of prosthetic valve complications, however, this often fails to identify the underlying mechanism of prosthesis failure. Recently, cardiac CT has emerged as an imaging technique capable of providing high isotropic spatial resolution of the prosthetic valve and its utility can provide important complementary diagnostic information. In this pictorial review, we present a series of common prosthetic aortic valve complications imaged with cardiac CT and demonstrate how use of this modality can enhance diagnostic accuracy.

Prosthetic Aortic Valve Thrombosis

“…On the contrary, pannus tends to have a HU >145 (322 ± 122), with lesions with a HU of 90-145 being indeterminate. 16,17 In addition, the location and timing of occurrence of a lesion provide further details that aid in determining its etiology. Pannus is predominantly circumferential compared to more irregularly shaped thrombotic lesions.…”

Subclinical Thrombosis on Mechanical Aortic Valve: Should Cardiac Computed Tomography Be Included in Routine Evaluation?

“…Currently, she is taking aspirin once daily and warfarin (INR 2.5–3.0) without signs of systemic embolism. This case displays the role of cardiac CT in detecting subclinical prosthetic valve thrombosis, 1) 2) 3) when the Doppler findings are out of the reference range but not diagnostic.…”

The Role of Multimodality Imaging in Left-Sided Prosthetic Valve Dysfunction

“…CT allows the accurate visualization of valve anatomy and it is particularly helpful for the detection of valve thrombosis and pannus formation. Specific CT visualizations include stent frame expansion and eccentricity index, degree of leaflet/s thickening or hypoattenuation [41], motion reduction and calcification [42]. CT is therefore essential and should be performed systematically to assess bioprosthetic SVD.…”