Imaging of the mechanical heart valve pannus formation with multidetector computerised tomography

Gündüz, Sabahattin; Özkan, Mehmet; Biteker, Murat; Güneysu, Tahsin

doi:10.1016/j.ejcts.2010.01.013

Cited by 10 publications

(4 citation statements)

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“…The combination of a new or increasing transvalvular gradient, as determined hemodynamically or echocardiographically, in the presence of a normally functioning valve on CF may suggest pannus formation . Recently, multislice computed tomography (Philips Brilliance 64‐slice MDCT scanner, Philips) has been proven to be a useful tool in the diagnosis of pannus, which is beyond the scope of this article.…”

Section: Fluoroscopy and Echocardiography In Differential Diagnosis Omentioning

confidence: 99%

The Current Status of Fluoroscopy and Echocardiography in the Diagnosis of Prosthetic Valve Thrombosis—A Review Article

Gürsoy¹,

Kalçık

Karakoyun³

et al. 2014

Echocardiography

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Prosthetic valve thrombosis (PVT) is a potentially life-threatening complication of heart valve replacement. Early diagnosis is crucial for the prevention of significantly morbid and lethal complications. Cinefluoroscopy (CF) and echocardiography have been widely used for diagnosing PVT. In recent years, the role of CF has declined since the introduction of transesophageal echocardiography and the great improvements in ultrasound technology including real time three-dimensional imaging. Nevertheless, both echocardiography and CF provide different kinds of information on prosthesis function, and therefore they are considered as complementary and not alternative. In this review, we aimed to summarize the current status of CF and echocardiography in the diagnosis of PVT.

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Section: Fluoroscopy and Echocardiography In Differential Diagnosis Omentioning

confidence: 99%

The Current Status of Fluoroscopy and Echocardiography in the Diagnosis of Prosthetic Valve Thrombosis—A Review Article

Gürsoy¹,

Kalçık

Karakoyun³

et al. 2014

Echocardiography

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“…Thrombus is seen early after surgery, is adherent to the aortic side of an aortic valve prosthesis, and has lower attenuation (<200 HU) (Fig 21b). Pannus is seen late after surgery, is located on the ventricular side (74), and has higher attenuation (>200 HU) (87,88). A recent study showed that a cutoff of 145 HU is useful in distinguishing thrombus from pannus, with 87.5% sensitivity and 96% specificity (88).…”

Section: Infective Endocarditis and Vegetation-phvmentioning

confidence: 99%

“…It may cause LVOT obstruction and may be located on the atrial side of the mitral valve (22). Although earlier studies showed that pannus has lower attenuation comparable to that of the ventricular septum (14), recent studies have shown that pannus has higher attenuation (>200 HU, >145 HU cutoff) (87,95) than thrombus owing to dense connective tissue and fibrocellular overgrowth with higher x-ray absorption, along with enhancement of dense tissues through capillary structures and the presence of calcification (87,88).…”

Section: Infective Endocarditis and Vegetation-phvmentioning

confidence: 99%

Multimodality Imaging of Complications of Cardiac Valve Surgeries

Rajiah¹,

Moore²,

Saboo³

et al. 2019

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Replacement with a prosthetic heart valve (PHV) remains the definitive surgical procedure for management of severe cardiac valve disease. PHV dysfunction is uncommon but can be a life-threatening condition. The broad hemodynamic and pathophysiologic manifestations of PHV dysfunction are stenosis, regurgitation, and a stuck leaflet. Specific structural abnormalities that cause PHV dysfunction include prosthetic valve-patient mismatch, structural failure, valve calcification, dehiscence, paravalvular leak, infective endocarditis, abscess, pseudoaneurysm, abnormal connections, thrombus, hypoattenuating leaflet thickening, and pannus. Multiple imaging modalities are available for evaluating a PHV and its dysfunction. Transthoracic echocardiography is often the first-line imaging modality, with additional modalities such as transesophageal echocardiography, CT, MRI, cine fluoroscopy, and nuclear medicine used for further characterization and establishing a specific cause. The authors review PHVs and the role of imaging modalities in evaluation of PHV dysfunction and illustrate the imaging appearances of different complications.

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“…Since a pannus is a reactive process starting at the ventricular wall that evolves to invade the prosthetic annular portion, its tissue attenuation should appear similar to that of the ventricular septum. Therefore, a pannus should have a Hounsfield unit value similar to that of the ventricular septum (51).…”

Section: Obstruction (Thrombosis Vs Pannus)mentioning

confidence: 99%

Complications of Aortic Valve Surgery: Manifestations at CT and MR Imaging

et al. 2012

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Aortic valve replacement accounts for a significant portion of cardiac surgeries in the United States. Despite advances in prosthetic heart valve design, surgical technique, and postoperative care, complications after aortic valve replacement remain a leading cause of morbidity and mortality. Routine surveillance of prosthetic heart valves with transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and fluoroscopy is important, as these techniques allow accurate detection of prosthetic valve dysfunction. However, echocardiography and fluoroscopy may not allow identification of the specific underlying cause, including paravalvular leak, dehiscence, endocarditis, obstruction, structural failure, pseudoaneurysm formation, aortic dissection, and hemolysis. Magnetic resonance (MR) imaging and computed tomography (CT) have an emerging role as diagnostic tools complementary to conventional imaging for detection and monitoring of complications after aortic valve replacement. The choice between CT and MR imaging depends on individual patient characteristics, the type of prosthetic valve, and the acuity of the clinical situation. In general, screening with TTE followed by TEE is recommended. When results of TTE and TEE are inconclusive, cardiac CT and MR imaging should be considered. The choice between these imaging techniques depends on the presence of patient-specific contraindications to CT or MR imaging.

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Imaging of the mechanical heart valve pannus formation with multidetector computerised tomography

Cited by 10 publications

References 0 publications

The Current Status of Fluoroscopy and Echocardiography in the Diagnosis of Prosthetic Valve Thrombosis—A Review Article

The Current Status of Fluoroscopy and Echocardiography in the Diagnosis of Prosthetic Valve Thrombosis—A Review Article

Multimodality Imaging of Complications of Cardiac Valve Surgeries

Complications of Aortic Valve Surgery: Manifestations at CT and MR Imaging

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