Reliability, Agreement, and Presentation of a Reference Standard for Assessing Implanted Heart Valve Sizes by Multidetector-Row Computed Tomography

Suchá, Dominika; Daans, Ceranza G.; Symersky, Petr; Planken, R. Nils; Mali, Willem P.Th.M.; Herwerden, Lex A. van; Budde, Ricardo P.J.

doi:10.1016/j.amjcard.2015.03.048

Cited by 13 publications

(1 citation statement)

References 19 publications

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“…First, no interand intra-observer variability for EI measurements was performed. However, excellent reproducibility for diameter measurements in prosthetic valves using CT was shown previously using similar methodology [28]. Also, in THVs, no difference between MDCT and three-dimensional transesophageal echocardiography was found for annular eccentricity assessment [29].…”

Section: Discussionmentioning

confidence: 76%

Surgically implanted aortic valve bioprostheses deform after implantation: insights from computed tomography

et al. 2020

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Objective Little is known about the prevalence and degree of deformation of surgically implanted aortic biological valve prostheses (bio-sAVRs). We assessed bio-sAVR deformation using multidetector-row computed tomography (MDCT). Methods Three imaging databases were searched for patients with MDCT performed after bio-sAVR implantation. Minimal and maximal valve ring diameters were obtained in systole and/or diastole, depending on the acquired cardiac phase(s). The eccentricity index (EI) was calculated as a measure of deformation as (1 − (minimal diameter/maximal diameter)) × 100%. EI of < 5% was considered none or trivial deformation, 5-10% mild deformation, and > 10% non-circular. Indications for MDCT and implanted valve type were retrieved. Results One hundred fifty-two scans of bio-sAVRs were included. One hundred seventeen measurements were performed in systole and 35 in diastole. None or trivial deformation (EI < 5%) was seen in 67/152 (44%) of patients. Mild deformation (EI 5-10%) was seen in 59/152 (39%) and non-circularity was found in 26/152 (17%) of cases. Overall, median EI was 5.5% (IQR 3.4-7.8). In 77 patients, both systolic and diastolic measurements were performed from the same scan. For these scans, the median EI was 6.5% (IQR 3.4-10.2) in systole and 5.1% (IQR3.1-7.6) in diastole, with a significant difference between both groups (p = 0.006). Conclusions Surgically implanted aortic biological valve prostheses show mild deformation in 39% of cases and were considered non-circular in 17% of studied valves. Key Points • Deformation of surgically implanted aortic valve bioprostheses (bio-sAVRs) can be adequately assessed using MDCT. • Bio-sAVRs show at least mild deformation (eccentricity index > 5%) in 56% of studied cases and were considered non-circular (eccentricity index > 10%) in 17% of studied valves. • The higher deformity rate found in bio-sAVRs with (suspected) valve pathology could suggest that geometric deformity may play a role in leaflet malformation and thrombus formation similar to that of transcatheter heart valves.

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Section: Discussionmentioning

confidence: 76%