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The clinical significance of perivalvular pannus in prosthetic mitral valves: Can cardiac CT be helpful?

Authors
 Suyon Chang  ;  Young Joo Suh  ;  Kyunghwa Han  ;  Jin Young Kim  ;  Young Jin Kim  ;  Byung-Chul Chang  ;  Byoung Wook Choi 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.249 : 344-348, 2017 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2017
Keywords
Computed tomography ; Mitral valve ; Pannus ; Prosthetic valve obstruction ; Valve prostheses
Abstract
BACKGROUND: The clinical significance of pannus in the prosthetic mitral valve (MV) is not well documented. OBJECTIVES: To investigate the clinical significance of pannus on cardiac computed tomography (CT) in patients with a prosthetic MV. METHODS: A total of 130 patients with previous MV replacement who underwent cardiac CT were retrospectively included in this study. The presence of pannus, paravalvular leak (PVL) around the prosthetic MV and limitation of motion (LOM) of the MV were analyzed using CT. Between patients with MV pannus and those without pannus, CT, echocardiographic, and redo-surgery findings were compared. The diagnostic performance of CT and transesophageal echocardiography (TEE) for the detection of MV pannus was also compared, using surgical findings as a standard reference. RESULTS: MV pannus was observed on cardiac CT in 32.3% of the study population. Patients with MV pannus detected on CT more commonly had LOM (28.2% vs. 15.2%) and less frequently had PVL of the prosthetic MV (16.7% vs. 25%) than patients without MV pannus (P>0.05). Prosthetic valve obstruction (PVO) due prosthetic MV pannus requiring redo-surgery was present in only five patients (11.9%). Cardiac CT detected MV pannus with sensitivity of 65.2% and specificity of 80.9% and showed better diagnostic performance than TEE (P<0.05). CONCLUSIONS: Prosthetic MV pannus can frequently be seen on cardiac CT. However, its clinical significance should be assessed with careful consideration, because PVO due to MV pannus is relatively uncommon, and pannus can be seen in patients without any clinical problems.
Full Text
https://www.sciencedirect.com/science/article/pii/S0167527317324932
DOI
10.1016/j.ijcard.2017.09.169
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Jin Young(김진영)
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Chang, Byung Chul(장병철)
Chang, Su Yon(장수연)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160191
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