Dysfunction of an ATS valve in the aortic position: the first reported case caused by pannus formation

Teshima, Hideki; Aoyagi, Shigeaki; Hayashida, Nobuhiko; Shojima, Takahiro; Takagi, Kazuyoshi; Arinaga, Kouichi; Yoshikawa, Kazuhiro

doi:10.1007/s10047-005-0317-9

Cited by 17 publications

(16 citation statements)

References 8 publications

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“…Our study vs. existing literature Until now, there have been only some scattered case reports or case series in the literature on the use of MDCT to diagnose prosthetic valve dysfunction [12][13][14][15][16][17]. Although these studies reported encouraging images and diagnostic results, they may have been confounded by a severe selection bias due to the inherent limitation of the article format.…”

Section: Discussionmentioning

confidence: 62%

“…Pannus formation was defined according to previous case reports [13,16,17] and our clinical experience as a small low-density region located at the inflow side of the prosthetic valve suture ring. Care was taken to exclude the beam-hardening artifact, which was defined as a black shining line projecting outwards from the dense portion of the device (Fig.…”

Section: Mdct Of Prosthetic Heart Valvesmentioning

confidence: 99%

“…In prosthetic heart valve evaluation, several case reports and case series have used MDCT with encouraging results [12][13][14][15][16][17]. These reports suggest that MDCT could be a good noninvasive imaging modality for prosthetic heart valve evaluation.…”

Section: Introductionmentioning

confidence: 96%

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Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard

et al. 2008

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The purpose was to compare the findings of multi-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiography (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) and pseudoaneurysm formation. Patients indicated for surgery received an operation within 1 week. The MDCT findings were compared with the operative findings. One patient with a Björk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCT was 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCT or TTE. Six patients received an operation that included three redo aortic valve replacements, two redo mitral replacements and one Amplatzer ductal occluder occlusion of a mitral paravalvular leak. The concordance of MDCT for diagnosing and localizing prosthetic valve disorders and the surgical findings was 100%. Except for images impaired by severe beam-hardening artifacts, MDCT provides excellent delineation of prosthetic valve disorders.

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Section: Discussionmentioning

confidence: 62%

Section: Mdct Of Prosthetic Heart Valvesmentioning

confidence: 99%

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Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard

et al. 2008

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“…CT images can also help visualize the morphology and motion of native and diseased stenotic aortic valves and precisely measure aortic valve opening areas. Several studies [39][40][41][42][43][44][45] suggest that multidetector CT can help assess mechanism of dysfunction in mechanical prosthetic heart valve disorders.…”

Section: Discussionmentioning

confidence: 99%

Analysis of degenerated aortic valve bioprosthesis by segmentation of preoperative CT images

Ruggieri

Wang

Esneault

et al. 2012

IRBM

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International audienceIn the next future. transcatheter aortic valve implantation could represent a minimally invasive option in case of bioprosthesis failure for patients at high surgical risk. CT based preoperative planning of this procedure could be useful to optimize valve-in-valve implantation. In this context, bioprosthesis 3D analysis seems to be necessary. particularly for leaflets. The goal of this study was to propose different methods to segment and characterize a degenerated bioprosthesis using standard preoperative CT scan images in order to map structural injury of bioprosthesis and. ultimately, to plan the best positioning for valve-in-valve implantation. We report our preliminary results on segmentation of a degenerated bioprosthesis in aortic position. Three different methods have been tested and all allowed obtaining segmentation of the different bioprosthesis components. Results were compared by means of quantitative criteria. Explanted bioprosthesis CT images were used as reference. Semi-automatic segmentation seems to provide an interesting approach for the morphological characterization of degenerated hioprosthesis

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“…15 Over the past 5 years, a few case reports [16][17][18][19] and research studies [20][21][22][23][24][25][26][27][28] with limited number of patients have been published regarding the use of multidetector computed tomography (MDCT) for the 2…”

Section: See Editorial By Bonnichsen and Pellikka See Clinical Perspementioning

confidence: 99%

Sixty-Four–Section Cardiac Computed Tomography in Mechanical Prosthetic Heart Valve Dysfunction

Gündüz

Özkan

Kalçık

et al. 2015

Circ: Cardiovascular Imaging

105

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Background-Distinguishing pannus and thrombus in patients with prosthetic valve dysfunction is essential for the selection of proper treatment. We have investigated the utility of 64-slice multidetector computed tomography (MDCT) in distinguishing between pannus and thrombus, the latter amenable to thrombolysis. Methods and Results-Sixty-two (23 men, mean age 44±14 years) patients with suspected mechanical prosthetic valve dysfunction assessed by transesophageal echocardiography were included in this prospective observational trial. Subsequently, MDCT was performed before any treatment was started. Periprosthetic masses were detected by MDCT in 46 patients, and their attenuation values were measured as Hounsfield Units (HU). Patients underwent thrombolysis unless contraindicated, and those with a contraindication or failed thrombolysis underwent surgery. A mass which was completely lysed or surgically detected as a clot was classified as thrombus, whereas a mass which was surgically detected as tissue overgrowth was classified as pannus. A definitive diagnosis could be achieved in 37 patients with 39 MDCT masses (22 thrombus and 17 pannus). The mean attenuation value of 22 thrombotic masses was significantly lower than that in 17 pannus (87±59 versus 322±122; P<0.001). Area under the receiver operating characteristic curve was 0.96 (95% confidence interval: 0.91-0.99; P<0.001), and a cutoff point of HU≥145 provided high sensitivity (87.5%) and specificity (95.5%) in discriminating pannus from thrombus. Complete lysis was more common for masses with HU<90 compared with those with HU 90 to 145 (100% versus 42.1%; P=0.007). Conclusions-Sixty-four slice MDCT is helpful in identifying masses amenable to thrombolysis in patients with prosthetic valve dysfunction. A high (HU≥145) attenuation suggests pannus overgrowth, whereas a lower value is associated with thrombus formation. A higher attenuation (HU>90) is associated with reduced lysis rates. (Circ Cardiovasc Imaging. 2015;8:e003246.

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Dysfunction of an ATS valve in the aortic position: the first reported case caused by pannus formation

Cited by 17 publications

References 8 publications

Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard

Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard

Analysis of degenerated aortic valve bioprosthesis by segmentation of preoperative CT images

Sixty-Four–Section Cardiac Computed Tomography in Mechanical Prosthetic Heart Valve Dysfunction

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