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

Authors
 Young Joo Suh  ;  Young Jin Kim  ;  Sak Lee  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Jin Hur  ;  Byoung Wook Choi  ;  Byung-Chul Chang 
Citation
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol.31(6) : 1271-1280, 2015 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 
ISSN
 1569-5794 
Issue Date
2015
MeSH
Adult ; Age Factors ; Aortic Valve/diagnostic imaging* ; Aortic Valve/physiopathology ; Aortic Valve/surgery* ; Chi-Square Distribution ; Female ; Heart Valve Diseases/diagnostic imaging* ; Heart Valve Diseases/physiopathology ; Heart Valve Diseases/surgery* ; Heart Valve Prosthesis* ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/instrumentation* ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prosthesis Design ; Prosthesis Failure* ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed* ; Treatment Outcome
Abstract
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.
Full Text
http://link.springer.com/article/10.1007%2Fs10554-015-0683-1
DOI
10.1007/s10554-015-0683-1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Chang, Byung Chul(장병철)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140516
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