Type:
Educational Exhibit
Keywords:
Cardiac, Arteries / Aorta, Cardiovascular system, Vascular, CT, CT-Angiography, Complications, Diagnostic procedure, Education, Aneurysms, Education and training, Not applicable, Performed at one institution
Authors:
M. Gredilla1, M. LETURIA ETXEBERRIA2, A. Serdio3, A. Luis Fernández3, J. Burgos Ruiz3, J. Badiola Molinuevo4; 1DONOSTIA/ES, 2San Sebastian, Gipuzkoa/ES, 3Donostia - San Sebastián/ES, 4SAN SEBASTIAN/ES
DOI:
10.26044/ecr2020/C-09924
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).
Transthoracic echocardiography is often the first imaging modality used, with high spatial and temporal resolution, and hemodynamic information. Transoesophageal echocardiography is an alternative when higher resolution is needed.
Multi-detector CT and cardiac-MR are non-invasive tools that allow assessment of PHV, help identify underlying cause, ancillary findings and define treatment strategies.
They require electrocardiographic gating to minimize motion artefacts, and β-blockers, if not contraindicated, to achieve low heart rates (60-70 bpm).
Evaluation of PHV with axial images only can be difficult. MPR and 3D reformatted images enable better visualization and depiction of findings.