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Assessment of Mitral Paravalvular Leakage After Mitral Valve Replacement Using Cardiac Computed Tomography: Comparison With Surgical Findings.

Authors
 Young Joo Suh  ;  Geu-Ru Hong  ;  Kyunghwa Han  ;  Dong Jin Im  ;  Suyon Chang  ;  Yoo Jin Hong  ;  Hye-Jeong Lee  ;  Jin Hur  ;  Byoung Wook Choi  ;  Byung-Chul Chang  ;  Chi Young Shim  ;  Young Jin Kim 
Citation
 Circulation-Cardiovascular Imaging, Vol.9(6) : 004153-004153, 2016 
Journal Title
 Circulation-Cardiovascular Imaging 
ISSN
 1941-9651 
Issue Date
2016
MeSH
Adult ; Echocardiography, Doppler, Color* ; Echocardiography, Transesophageal* ; Female ; Heart Valve Prosthesis* ; Heart Valve Prosthesis Implantation/adverse effects* ; Heart Valve Prosthesis Implantation/instrumentation* ; Humans ; Male ; Middle Aged ; Mitral Valve/diagnostic imaging ; Mitral Valve/physiopathology ; Mitral Valve/surgery* ; Mitral Valve Insufficiency/diagnostic imaging* ; Mitral Valve Insufficiency/etiology ; Mitral Valve Insufficiency/physiopathology ; Predictive Value of Tests ; Prosthesis Failure* ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed* ; Treatment Outcome
Keywords
computed tomography ; diagnosis ; mitral valve ; paravavular regurgitation ; valve replacement
Abstract
BACKGROUND: The diagnostic performance of cardiac computed tomography (CT) for detection of paravalvular leakage (PVL) after mitral valve replacement has not been investigated in a large population. We aimed to investigate the diagnostic accuracy of CT for diagnosis of mitral PVL using surgical findings as the standard reference and to compare the diagnostic performance of CT with those of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). METHODS AND RESULTS: A total of 204 patients with previous mitral valve replacement who underwent cardiac CT were retrospectively included. The presence of mitral PVL was analyzed on CT, TTE, and TEE. In 78 patients who underwent redo-surgery, diagnostic performance for the detection of PVL for CT, TTE, and TEE were compared with surgical findings as the standard reference. The location of mitral PVL on CT and TEE was compared with surgical findings. Mitral PVL was present in 18.1% (37/204) on CT, in 16.2% (32/198) on TTE, and in 42.6% (29/68) on TEE. On the surgical field, PVL was identified in 41.0% (32/78). The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for detection of PVL were 96.9%, 97.8%, 96.9%, 97.8%, and 97.4% for CT; 81.3%, 95.6%, 92.9%, 87.8%, and 89.6% for TTE; and 96.2%, 95.8%, 96.2%, 95.8%, and 96.0% for TEE. CT and TEE identified the correct location of PVL in 75.9% (22/29) and 85.6% (19/23). CONCLUSIONS: Cardiac CT may have better diagnostic accuracy compared with TTE for the detection of mitral PVL and may be comparable to TEE for the detection and localization of PVL.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=01337498-201606000-00012&LSLINK=80&D=ovft
DOI
10.1161/CIRCIMAGING.115.004153
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
김영진(Kim, Young Jin) ORCID logo https://orcid.org/0000-0002-6235-6550
서영주(Suh, Young Joo) ORCID logo https://orcid.org/0000-0002-2078-5832
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
임동진(Im, Dong Jin) ORCID logo https://orcid.org/0000-0001-8139-5646
장병철(Chang, Byung Chul)
장수연(Chang, Su Yon)
최병욱(Choi, Byoung Wook) ORCID logo https://orcid.org/0000-0002-8873-5444
허진(Hur, Jin) ORCID logo https://orcid.org/0000-0002-8651-6571
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
홍유진(Hong, Yoo Jin) ORCID logo https://orcid.org/0000-0002-7276-0944
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146985
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