DOI 10.1007/s00330-008-1232-2 CARDIAC I-Chen Tsai

tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard Abstract The purpose was to compare the findings ofmulti-detector computed tomography (MDCT) in prosthetic valve disorders using the operative findings as a gold standard. In a 3-year period, we prospectively enrolled 25 patients with 31 prosthetic heart valves. MDCT and transthoracic echocardiog-raphy (TTE) were done to evaluate pannus formation, prosthetic valve dysfunction, suture loosening (para-valvular leak) and pseudoaneurysm formation. Patients indicated for sur-gery received an operation within 1 week. The MDCT findings were com-pared with the operative findings. One patient with a Björk-Shiley valve could not be evaluated by MDCT due to a severe beam-hardening artifact; thus, the exclusion rate for MDCTwas 3.2% (1/31). Prosthetic valve disorders were suspected in 12 patients by either MDCTor TTE. Six patients received an operation that included three redo aortic valve replacements, two redo mitral replacements and one Amplatzer ductal occluder occlusion of a mitral para-valvular leak. The concordance of MDCT for diagnosing and localizing prosthetic valve disorders and the sur-gical findings was 100%. Except for images impaired by severe beam-hard-ening artifacts, MDCT provides excel-lent delineation of prosthetic valve disorders