Abstract 2227: Feasibility And Accuracy Of 64-slice Computed Tomography For The Diagnosis Of Aortic Prosthetic Valve Complications
Objectives. This is the first prospective study designed to examine the feasibility and accuracy of multislice computed tomography (MSCT) to detect aortic prosthetic valve (APV) complications.
Background. Improvements in MSCT technologies allow assessment of native aortic and mitral valve. However, no data are available on the accuracy of MSCT to identify prosthetic valve complications.
Methods. Sixty-six consecutive patients (mean age: 59 ± 15.3 years; 46 males) with APV (53 mechanical and 13 bioprostheses) were assessed by echocardiography and 64-slice MSCT. Cinefluoroscopy was performed in patients with mechanical valves. Twenty-seven patients underwent MSCT for suspicion of APV complications: stroke (n=14), endocarditis (n=13), abnormal murmur and/or dyspnea (n=6). In forty-six patients MSCT was performed to assess the ascending aorta or to evaluate coronary artery disease.
Results. MSCT analysis of APV was feasible in 63 patients (95.4 %). On the basis of echocardiography and cinefluoroscopy, 22 patients had one or several anomalies on APV. MSCT correctly detected twenty of these patients (sensitivity: 90.9 %, specificity: 97.6 %, PPV: 95.2% and NPV: 95.2%). Sensitivity and specificity of MSCT for the detection of abscesses or aneurysms (n=13), vegetations or thrombi (n=5), paravalvular leaks (n=10) and abnormal ball or leaflet motion (n=3) were 92.3% and 100%, 100% and 98.3%, 90% and 100%, 100% and 100 % respectively. Two bioprostheses were stenotic and valve areas were correctly calculated.
Conclusion. MSCT appears to be a very promising tool to detect prosthetic valve complications. MSCT may be useful when echocardiography is inconclusive or to complete echocardiography in this population.