Learning objectives
To review several aortic complications following cardiac valve surgery.
To describe the imaging techniques that will better characterise them.
To highlight the importance of recognising them, to establish the best possible treatment and prevent complications.
Background
Valve heart disease is a common condition that accounts for a large number of cardiac diseases. Aortic valve is the most commonly affected one and surgical replacement, with prosthetic valve (PHV), remains the definitive treatment.
Complications following replacement are infrequent but potentially life-threatening; therefore, life-long follow-up is required.
Accurate and early diagnosis of the underlying mechanism is challenging, but mandatory to allow for proper decision-making.
Diagnosis is based on radiological tests. Multiple imaging techniques are available; with advantages and disadvantages (Fig. 1 / Table 1)....
Findings and procedure details
The aim when replacing heart valves is to achieve a normal function, similar to that prior to disease. PHV should adapt to the aortic root and cover the whole circumference of ascending aorta. (Fig. 2)
Complications can be divided into two groups. Herein, we describe some.
1. Haemodynamic consequences:
a-Stenosis:
Narrowing of the orifice of PHV. Certain degree of stenosis may be seen in normally functioning PHVs.
Pathologic causes include high cardiac output, prosthetic-patient mismatch and structural failure (calcification, obstruction).
At CT the orifice area...
Conclusion
Complications of thoracic aorta following PHV replacement are rare but life-threatening, making accurate diagnosis crucial.
PHV dysfunctions can be divided into two groups; haemodynamic and structural complications, each one with particular characteristics that may be overlapped. Hence, adequate knowledge of normal function, familiarity with complications and radiographic features is essential for diagnosis and treatment planning.
Echocardiography is the first diagnostic technique to be performed; however, CT and MR provide complementary datato that yielded by echocardiography; overallinformation about valve structure and function and surrounding structures.
Post-processing...
Personal information and conflict of interest
M. Gredilla; Donostia/ES - Author at Hospital Universitario Donostia M. Leturia Etxeberria; San Sebastian, GIPUZKOA/ES - nothing to disclose A. Serdio; Donostia - San Sebastián/ES - nothing to disclose A. Luis Fernández; Donostia - San Sebastián/ES - nothing to disclose J. Burgos Ruiz; Donostia - San Sebastián/ES - nothing to disclose J. Badiola Molinuevo; SAN SEBASTIAN/ES - nothing to disclose
References
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