Plain Gated64 slice MultiDetector ComputerizedTomographic(MDCT Assessment forDysfunction of Prosthetic HeartValve

Tahir Naveed; Moazzam Ali Naqvi; Ammar Rashid; Imran Saeed; Bilal S. Mohydin; Muhammad Ayub

BACKGROUND: Prosthetic Heart Valves (PHV) dysfunction is a rare but serious complication. Early diagnosis with imaging is essential.The most common diagnostic imaging is TTE, TEE and fluoroscopy.The objective of this study was to assess dysfunction of PHV on MDCT. MATERIAL AND METHODS: This study was done at Punjab Institute of Cardiology from January 2018 to December 2018 .Inclusionmeanwereenrolled. The patients who had inability to hold the breath, and contraindication to radiation were excluded. Plain gated MDCT of the heart wasdone on low voltage and tube current to reduce the radiation dose. Retrospective gated data was analyzed for the assessment of prostheticheart valve. CT cine data was analyzed for visual assessment of the mobility of discs of the valves along with opening and closing angles wernoted for valve function. RESULTS: A total of thirty patients were analyzed for prosthetic heart valve dysfunction. Among these nineteen were males and eleven were females.The total number of prosthetic valves assessed on MDCT were thirty nine.Ten (29.41%) bi-leaflet prosthetic valves had adequate mobilityof both discs and opening(750-850)and closing angles(250-300)signifying normal function of the valves and twenty-four bi-leaflet valves (70.58%)had restricted mobility of the discs of the valves either one or both. Among the four Starr Edwards prosthetic valves three had normal mobility of the ball and one patient had restricted mobility of the ball in the cage. Only one patient had single disc valve which had normal mobility of the disc having opening and closing angle of 650 and 00 respectively .Thirteen patients had MVR,09 patients had AVR,07 patients had DVR and one patients had Triple valve replacement. Mean radiation dose of plain gated MDCT in mSv was -3.03±0.91 Max 5.1 min 1.6 mSv. CONCLUSION: Plain gated MDCT is capable to assess the prosthetic heart valve dysfunction either alone or in combination with fluoroscopy and transthoracic echocardiography.