Usefulness of a multidetector-row computed tomography scanner for detecting pannus formation

Teshima, Hideki; Hayashida, Nobuhiko; Fukunaga, Shuji; Tayama, Eiki; Kawara, Takemi; Aoyagi, Shigeaki; Uchida, Masafumi

doi:10.1016/s0003-4975(03)01531-5

Cited by 71 publications

(52 citation statements)

References 14 publications

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“…Whereas operative management is the preferred treatment for pannus, thrombolysis is the common treatment for thrombus. 3 Our case demonstrates how MDCT can prove to be a useful tool in the diagnosis of pannus. …”

Section: Supplement 2 Ct Images Of Prosthetic Aortic Valvementioning

confidence: 79%

Utility of Cardiac Computed Tomography for Assessment of Prosthetic Aortic Valve Dysfunction with Pannus Formation

Kassi

Garg

Chang

2013

Methodist DeBakey Cardiovascular Journal

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A 61-year-old female with a history of atrial fibrillation, and a distant-history mechanical St. Jude's aortic valve replacement, presented after undergoing an episode of ventricular tachycardia and worsening heart failure. A transthoracic echocardiogram revealed a dilated left ventricle (LV) with moderately depressed ejection fraction (LVEF of 44%). The international normalized ratio (INR) was 2.1. The prosthetic valve could not be well visualized; however, the Doppler velocities were suggestive of prosthetic valve dysfunction ( Figures 1A and 1B). A transesophageal

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Section: Supplement 2 Ct Images Of Prosthetic Aortic Valvementioning

confidence: 79%

Utility of Cardiac Computed Tomography for Assessment of Prosthetic Aortic Valve Dysfunction with Pannus Formation

Kassi

Garg

Chang

2013

Methodist DeBakey Cardiovascular Journal

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“…We have previously reported the usefulness of electrocardiographically (ECG)-gated multidetector-row computed tomography (MDCT) for detecting subprosthetic overgrown pannus in the aortic position in several cases. [12][13][14] In this study, we evaluated the role of MDCT in diagnosing PVO and the utility of MDCT in identifying the underlying causes of PVO in the aortic position. …”

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confidence: 99%

Evaluation of Prosthetic Valve Obstruction on Electrocardiographically Gated Multidetector-Row Computed Tomography

Ueda

Teshima

Fukunaga

et al. 2013

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ortic valve replacement (AVR) with a prosthetic cardiac valve is an established therapeutic approach for significant aortic valve disease. Despite recent advances in prosthetic valve technology and anticoagulant therapy, prosthetic valve obstruction (PVO) due to thrombus or pannus is a serious and occasionally fatal valve-related complication. 1-8 The incidence of PVO due to pannus is generally estimated to be 0.1-0.6% per patient-year in the aortic position, 1,2,9 but obstruction of an aortic prosthetic valve caused by pannus is higher in frequency than previously reported and is detected even in asymptomatic patients. 2,4,10 Echocardiography and cineradiography are commonly used diagnostic techniques for PVO, 2,4,11 but identification of the exact cause of PVO, such as thrombus or pannus, is difficult. We have previously reported the usefulness of electrocardiographically (ECG)-gated multidetector-row computed tomography (MDCT) for detecting subprosthetic overgrown pannus in the aortic position in several cases. [12][13][14] In this study, we evaluated the role of MDCT in diagnosing PVO and the utility of MDCT in identifying the underlying causes of PVO in the aortic position. Methods PatientsThe current study was approved by the Ethics Committee of Kurume University, and written informed consent was obtained from all participating patients after they were notified of the risks of radiation exposure and complications due to use of contrast medium.

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“…24 Data on the value of measuring CT attenuation values for distinguishing prosthetic valve thrombosis from pannus formation are sparse and equivocal. 24,27,28 To date, the largest study with direct comparison of MDCT findings and surgery (n=9) demonstrated higher mean CT attenuation values of pannus when compared with the intraventricular septum. 24 Although the generalizability of these previous data is uncertain because CT attenuation values vary between different scanners and convolution kernels, our findings of similar CT attenuation values of the THV cusp masses when compared with the intraventricular septum further strengthen that these masses represent thrombi rather than pannus.…”

Section: Discussionmentioning

confidence: 97%

Early Aortic Transcatheter Heart Valve Thrombosis

Leetmaa

Hansson

Leipsic

et al. 2015

Circ: Cardiovascular Interventions

180

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Background— Early stent valve thrombosis after transcatheter aortic valve implantation (TAVI) is a rare complication, which is diagnosed based on the appearance of clinical symptoms of heart failure and echocardiographic findings. After TAVI, transthoracic echocardiography is performed to assess transcatheter heart valve (THV) function. However, preliminary reports indicate the potential additive clinical value of multidetector computed tomography (MDCT) for the diagnosis of THV thrombosis. We sought to determine the value of MDCT for the diagnosis of THV thrombosis and the frequency of this complication after balloon-expandable TAVI. Methods and Results— MDCT was performed in 140 patients within 1 to 3 months after TAVI with the Edwards Sapien XT THV to assess the presence of THV thrombosis and THV stent geometry. Post-TAVI MDCT identified THV thrombosis in 5 patients (4%). Of note, 4 of these patients were asymptomatic and had a normal transthoracic echocardiographic examination without signs of thrombus formation or flow obstruction. In patients with THV thrombosis, a left ventricular ejection fraction of <35% was present in 3 (60%), whereas 2 (40%) did not receive standard post-TAVI dual-antiplatelet therapy. Neither THV underexpansion nor THV noncircularity was detected in patients with THV thrombosis. Conclusions— Post-TAVI MDCT is a valuable tool for the diagnosis of THV thrombosis, and this complication seems to be more common than previously anticipated. Larger studies are required to identify specific risk factors of THV thrombosis.

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Usefulness of a multidetector-row computed tomography scanner for detecting pannus formation

Cited by 71 publications

References 14 publications

Utility of Cardiac Computed Tomography for Assessment of Prosthetic Aortic Valve Dysfunction with Pannus Formation

Utility of Cardiac Computed Tomography for Assessment of Prosthetic Aortic Valve Dysfunction with Pannus Formation

Evaluation of Prosthetic Valve Obstruction on Electrocardiographically Gated Multidetector-Row Computed Tomography

Early Aortic Transcatheter Heart Valve Thrombosis

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