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Utility of cardiac computed tomography for evaluation of pannus in mechanical aortic valve

 Young Joo Suh  ;  Young Jin Kim  ;  Sak Lee  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Jin Hur  ;  Byoung Wook Choi  ;  Byung-Chul Chang 
 International Journal of Cardiovascular Imaging, Vol.31(6) : 1271-1280, 2015 
Journal Title
 International Journal of Cardiovascular Imaging 
Issue Date
The clinical significance of pannus detected on computed tomography (CT) has not yet been investigated. The purposes of this study were to investigate the clinical significance of pannus detected on cardiac CT in patients who underwent aortic valve replacement (AVR) with mechanical valves, and to determine predictors for pannus severity. A total of 92 patients who underwent cardiac CT and TTE and who had undergone mechanical AVR were included. The geometric orifice area (GOA), the presence of limitation of motion (LOM) and pannus were evaluated on CT. The GOA, presence of LOM, and presence and severity of pannus were compared with echocardiographic parameters. Logistic regression analysis was performed to determine the predictors for pannus severity. The GOA on CT positively correlated with effective orifice area on TTE (r = 0.733, P < 0.0001). Pannus was found in 77.2% and LOM in 14.0%. With increasing pannus severity, mean transvalvular pressure gradient (PG) was significantly higher (P < 0.0001). Patients with elevated PG showed a smaller GOA, a higher incidence of pannus, more severe pannus and LOM than patients with normal PG (P < 0.05). Small valve size (≤19 mm), Carbomedics valve, rheumatic etiology, and young age at AVR (<48.8 years) were independent predictors of moderate to severe pannus (P < 0.05). Cardiac CT is helpful in the evaluation of pannus formation in patients with mechanical aortic valves. Moderate to severe pannus formation frequently occurred in patients with small mechanical valve size, Carbomedics valves, rheumatic heart disease and young age at AVR.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실)
Yonsei Authors
김영진(Kim, Young Jin) ; 서영주(Suh, Young Joo) ; 이삭(Lee, Sak) ; 이혜정(Lee, Hye Jeong) ; 장병철(Chang, Byung Chul) ; 최병욱(Choi, Byoung Wook) ; 허진(Hur, Jin) ; 홍유진(Hong, Yoo Jin)
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