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

Kassi, Mahwash; Garg, Nadish; Chang, Su Min

doi:10.14797/mdcj-9-3-174

Cited by 8 publications

(7 citation statements)

References 3 publications

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“…Using beta-blockers to reduce the heart rate before performing a CT scan makes it possible to overcome the problem of temporal resolution. Post-processing methods of cardiac CT provides complementary information for assessing the dysfunction of prosthetic valves ( 13 14 15 16 20 21 26 ), and CT-derived pannus parameters are known to correlate with the hemodynamic parameters measured on echocardiographies ( 7 8 10 12 ). However, the previous studies did not evaluate the interval changes of pannus extent in the same patients, and they could not clearly demonstrate whether the pannus formation developed suddenly, or would be enlarged over time.…”

Section: Discussionmentioning

confidence: 99%

“…However, as it is often difficult to visualize the exact cause of prosthetic valve dysfunction even by TEE, cardiac CT can be used as a complementary method to more clearly evaluate the dysfunction of the prosthetic aortic valve (2,(7)(8)(9)(10)(11)(12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have demonstrated that the extent of pannus is related to the hemodynamic disturbance detected on echocardiography. However, as it is often difficult to visualize the exact cause of prosthetic valve dysfunction even by TEE, cardiac CT can be used as a complementary method to more clearly evaluate the dysfunction of the prosthetic aortic valve ( 2 7 8 9 10 11 12 13 14 15 16 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings

박

구

하³

et al. 2020

J Korean Soc Radiol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings

박

구

하³

et al. 2020

J Korean Soc Radiol

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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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“…Recently, cardiac computed tomography (CT) has become an emerging technique in the evaluation of the prosthetic valve, including evaluation of pannus. A few studies have reported the utility of cardiac CT for detection of pannus formation, a cause of prosthetic valve dysfunction or obstruction in the aortic position [4][5][6][7][8][9]. However, those studies investigated only a small number of mechanical aortic valve types.…”

Section: Introductionmentioning

confidence: 99%

Utility of cardiac computed tomography for evaluation of pannus in mechanical aortic valve

Suh

Kim

Lee

et al. 2015

Int J Cardiovasc Imaging

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The clinical significance of pannus detected on computed tomography (CT) has not yet been investigated. The purposes of this study were to investigate the clinical significance of pannus detected on cardiac CT in patients who underwent aortic valve replacement (AVR) with mechanical valves, and to determine predictors for pannus severity. A total of 92 patients who underwent cardiac CT and TTE and who had undergone mechanical AVR were included. The geometric orifice area (GOA), the presence of limitation of motion (LOM) and pannus were evaluated on CT. The GOA, presence of LOM, and presence and severity of pannus were compared with echocardiographic parameters. Logistic regression analysis was performed to determine the predictors for pannus severity. The GOA on CT positively correlated with effective orifice area on TTE (r = 0.733, P < 0.0001). Pannus was found in 77.2% and LOM in 14.0%. With increasing pannus severity, mean transvalvular pressure gradient (PG) was significantly higher (P < 0.0001). Patients with elevated PG showed a smaller GOA, a higher incidence of pannus, more severe pannus and LOM than patients with normal PG (P < 0.05). Small valve size (≤19 mm), Carbomedics valve, rheumatic etiology, and young age at AVR (<48.8 years) were independent predictors of moderate to severe pannus (P < 0.05). Cardiac CT is helpful in the evaluation of pannus formation in patients with mechanical aortic valves. Moderate to severe pannus formation frequently occurred in patients with small mechanical valve size, Carbomedics valves, rheumatic heart disease and young age at AVR.

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

Cited by 8 publications

References 3 publications

Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings

Extent of Subprosthetic Pannus after Aortic Valve Replacement: Changes Over Time and Relationship with Echocardiographic Findings

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

Utility of cardiac computed tomography for evaluation of pannus in mechanical aortic valve

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