Coronary artery assessment by multidetector computed tomography in patients with prosthetic heart valvesReport as inadecuate




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European Radiology

, Volume 22, Issue 6, pp 1278–1286

First Online: 23 December 2011Received: 21 July 2011Revised: 10 November 2011Accepted: 16 November 2011

Abstract

ObjectivesPatients with prosthetic heart valves may require assessment for coronary artery disease. We assessed whether valve artefacts hamper coronary artery assessment by multidetector CT.

MethodsECG-gated or -triggered CT angiograms were selected from our PACS archive based on the presence of prosthetic heart valves. The best systolic and diastolic axial reconstructions were selected for coronary assessment. Each present coronary segment was scored for the presence of valve-related artefacts prohibiting coronary artery assessment. Scoring was performed in consensus by two observers.

ResultsEighty-two CT angiograms were performed on a 64-slice n = 27 or 256-slice n = 55 multidetector CT. Eighty-nine valves and five annuloplasty rings were present. Forty-three out of 1160 3.7% present coronary artery segments were non-diagnostic due to valve artefacts 14-82 patients. Valve artefacts were located in right coronary artery 15-43; 35%, left anterior descending artery 2-43; 5%, circumflex artery 14-43; 32% and marginal obtuse 12-43; 28% segments. All cobalt-chrome containing valves caused artefacts prohibiting coronary assessment. Biological and titanium-containing valves did not cause artefacts except for three specific valve types.

ConclusionsMost commonly implanted prosthetic heart valves do not hamper coronary assessment on multidetector CT. Cobalt-chrome containing prosthetic heart valves preclude complete coronary artery assessment because of severe valve artefacts.

Key Points• Most commonly implanted prosthetic heart valves do not hamper coronary artery assessment

• Prosthetic heart valve composition determines the occurrence of prosthetic heart valve-related artefacts

• Björk–Shiley and Sorin tilting disc valves preclude diagnostic coronary artery segment assessment

KeywordsComputed tomography Prosthetic heart valve Coronary artery disease Coronary artery Artefacts  Download fulltext PDF



Author: Jesse Habets - Renee B. A. van den Brink - Ruben Uijlings - Anje M. Spijkerboer - Willem P. Th. M. Mali - Steven A. 

Source: https://link.springer.com/



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