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Impact of Cardiac Computed Tomographic Angiography on Diagnostic and Therapeutic Decisions in Patients with Suspected Prosthetic Heart Valve Dysfunction
- Source :
- Journal of the Saudi Heart Association
- Publication Year :
- 2021
- Publisher :
- Saudi Heart Association, 2021.
-
Abstract
- Introduction Computed Tomography (CT) scan is a helpful tool to assess the coronary arteries and the great vessels. However, its routine use in the assessment of patients with suspected prosthetic valve dysfunction (PVD) has not been studied thoroughly. Objective To determine the impact of routine cardiac computed tomography angiography (CCTA) on diagnostic and therapeutic decisions in patients with suspected PVD. Methods and results This was a prospective cohort study that was conducted on 50 consecutive patients with suspected PVD who underwent both 64-slice ECG-gated CT and transesophageal echocardiography (TEE). The gold standard was the intraoperative findings. Surgery was performed in forty-six patients. ECG-gated CT showed findings that were not detected by TEE in sixteen patients (32%) namely aortic root abscess, aortic pseudoaneurysm, paravalvular leakage (PVL), sclero-calcific disruption of sutures as cause of PVL, mechanical prosthesis occluder malfunction, an underlying thrombus as cause of malfunction and finally presence of aortic dissection. Furthermore, CTA findings dictated treatment changes in fourteen patients (28%). Conclusion This study demonstrates that ECG-gated CTA has a complementary role to TEE in patients with suspected PVD. CCTA is more accurate in diagnosis of periannular complications (Aortic root abscess and Pseudo-aneurysm) and in delineating their anatomical relation to surrounding cardiac structures. Therefore CCTA can have important role in deciding and planning the method of correction whether surgical or percutaneous and has to be considered after TEE in patients with a high suspicion on PVD.
- Subjects :
- Aortic dissection
medicine.medical_specialty
Percutaneous
Transoesophageal echocardiography
business.industry
medicine.medical_treatment
Gold standard (test)
Prosthetic valves
medicine.disease
Prosthesis
Coronary arteries
medicine.anatomical_structure
Great vessels
medicine
Cardiac CT
Original Article
Radiology
Thrombus
Cardiology and Cardiovascular Medicine
business
Prospective cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 22125043 and 10167315
- Volume :
- 33
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of the Saudi Heart Association
- Accession number :
- edsair.doi.dedup.....28831df2f72ff5042a7c2c0d0ee9e3e1