Live 3D TEE Demonstrates and Guides the Management of Prosthetic Mitral Valve Obstruction

Chahal, Mangeet; Pandya, Utpal; Adlakha, Satjit; Khouri, Samer

doi:10.1111/j.1540-8175.2011.01412.x

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…When combined with cineradiography, both can demonstrate any abnormal small tissue extending from the left ventricular septum into the prosthetic aortic valve [10]. In technically inadequate or borderline cases, transoesophaged echocardiography (TEE) and more recently, the use of three-dimensional (3D) TEE was shown to be effective in diagnosis and visualization of leaflet immobility [1,11]. …”

Section: Commentarymentioning

confidence: 99%

Recurrent pannus formation causing prosthetic aortic valve dysfunction: Is excision without valve re-replacement applicable?

Darwazah

2012

J Cardiothorac Surg

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Prosthetic valve dysfunction at aortic position is commonly caused by pannus formation. The exact etiology is not known. It arises from ventricular aspect of the prosthesis encroaching its leaflets causing stenosis or it may remain localized causing left ventricular outflow tract obstruction without affecting valve function.The difference in location entails different approaches in management. Such a pathology requires surgical excision of the pannus with or without valve re-replacement.A recurrent pannus was observed in a female patient who needed repeated surgical intervention to excise a localized pannus without re-replacement of a well functioning prosthetic valve.Management of our case presents several questions, whether recurrence of pannus is caused by sparing the prosthetic valve, is it simply an exaggeration of an inflammatory healing process in certain individuals or is it ideal to re-replace the valve despite a well preserved function.

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Section: Commentarymentioning

confidence: 99%

Recurrent pannus formation causing prosthetic aortic valve dysfunction: Is excision without valve re-replacement applicable?

Darwazah

2012

J Cardiothorac Surg

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“…Data on the accuracy of two-dimensional TEE and three-dimensional TEE in the differentiation of thrombus from pannus formation are scarce 10 – 13 . This study was conducted to investigate the value of two-dimensional TEE and three-dimensional TEE to differentiate thrombus from pannus in LMVO patients, with a diagnosis confirmed by cardiac surgery and histopathology.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of two-dimensional and three-dimensional transesophageal echocardiography in detecting pannus and thrombus in left mechanical valve obstruction

Pham

Kirkpatrick

Duong

et al. 2023

Annals of Medicine &Amp; Surgery

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Aims: The aim of this study was to determine the accuracy of two-dimensional and three-dimensional transesophageal echocardiography (TEE) in the detection of pannus and thrombus in left mechanical valve obstruction (LMVO) compared with surgical and histopathology findings. Materials and methods: Patients with suspected LMVO on transthoracic echocardiography were enrolled consecutively. All patients underwent two-dimensional and three-dimensional TEE, and open-heart surgery to replace obstructed valves. Macroscopic and microscopic analysis of the excised masses was used as the gold standard for the diagnosis of thrombus and/or pannus. Results: Forty-eight patients [34 women (70.8%), age 49±13 years, New York Heart Association II: 68.8%, New York Heart Association III: 31.2%] were enrolled. In the diagnostic of thrombus, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of three-dimensional TEE were 89.2, 72.7, 85.4, 91.7, and 66.7%, respectively, compared with those of two-dimensional TEE (42.2, 66.7, 43.8, 95, and 7.1%, respectively). In the diagnosis of pannus, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of three-dimensional TEE were 53.3, 100, 85.4, 100, and 82.5%, respectively; compared with those of two-dimensional TEE (7.4, 90.5, 43.8, 50, and 43.2%, respectively). Receiver operating characteristic curves depict that the area under the curves of three-dimensional TEE was higher than the area under the curves of two-dimensional TEE in both diagnoses of thrombus and pannus (0.8560 vs. 0.7330, P=0.0427 and 0.8077 vs. 0.5484, P=0.005, respectively). Conclusions: This study indicated that three-dimensional TEE had a higher diagnostic value than two-dimensional TEE in the detection of thrombus and pannus in patients with LMVO, and can be a reliable imaging modality to identify the causes of LMVO.

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An unusual cause of left ventricular outflow tract obstruction: obstructive pannus on the left ventricular side of a mechanical mitral prosthesis

et al. 2014

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Live 3D TEE Demonstrates and Guides the Management of Prosthetic Mitral Valve Obstruction

Cited by 4 publications

References 9 publications

Recurrent pannus formation causing prosthetic aortic valve dysfunction: Is excision without valve re-replacement applicable?

Recurrent pannus formation causing prosthetic aortic valve dysfunction: Is excision without valve re-replacement applicable?

Diagnostic accuracy of two-dimensional and three-dimensional transesophageal echocardiography in detecting pannus and thrombus in left mechanical valve obstruction

An unusual cause of left ventricular outflow tract obstruction: obstructive pannus on the left ventricular side of a mechanical mitral prosthesis

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