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- Title
Surgically implanted aortic valve bioprostheses deform after implantation: insights from computed tomography.
- Authors
Faure, Marguerite E.; Suchá, Dominika; Schwartz, Fides R.; Symersky, Petr; Bogers, Ad J. J. C.; Gaca, Jeffrey G.; Koweek, Lynne M.; de Heer, Linda M.; Budde, Ricardo P. J.
- Abstract
<bold>Objective: </bold>Little is known about the prevalence and degree of deformation of surgically implanted aortic biological valve prostheses (bio-sAVRs). We assessed bio-sAVR deformation using multidetector-row computed tomography (MDCT).<bold>Methods: </bold>Three imaging databases were searched for patients with MDCT performed after bio-sAVR implantation. Minimal and maximal valve ring diameters were obtained in systole and/or diastole, depending on the acquired cardiac phase(s). The eccentricity index (EI) was calculated as a measure of deformation as (1 - (minimal diameter/maximal diameter)) × 100%. EI of < 5% was considered none or trivial deformation, 5-10% mild deformation, and > 10% non-circular. Indications for MDCT and implanted valve type were retrieved.<bold>Results: </bold>One hundred fifty-two scans of bio-sAVRs were included. One hundred seventeen measurements were performed in systole and 35 in diastole. None or trivial deformation (EI < 5%) was seen in 67/152 (44%) of patients. Mild deformation (EI 5-10%) was seen in 59/152 (39%) and non-circularity was found in 26/152 (17%) of cases. Overall, median EI was 5.5% (IQR 3.4-7.8). In 77 patients, both systolic and diastolic measurements were performed from the same scan. For these scans, the median EI was 6.5% (IQR 3.4-10.2) in systole and 5.1% (IQR3.1-7.6) in diastole, with a significant difference between both groups (p = 0.006).<bold>Conclusions: </bold>Surgically implanted aortic biological valve prostheses show mild deformation in 39% of cases and were considered non-circular in 17% of studied valves.<bold>Key Points: </bold>• Deformation of surgically implanted aortic valve bioprostheses (bio-sAVRs) can be adequately assessed using MDCT. • Bio-sAVRs show at least mild deformation (eccentricity index > 5%) in 56% of studied cases and were considered non-circular (eccentricity index > 10%) in 17% of studied valves. • The higher deformity rate found in bio-sAVRs with (suspected) valve pathology could suggest that geometric deformity may play a role in leaflet malformation and thrombus formation similar to that of transcatheter heart valves.
- Subjects
AORTIC valve; COMPUTED tomography; BIOPROSTHETIC heart valves; HEART valves; IMAGE databases
- Publication
European Radiology, 2020, Vol 30, Issue 5, p2651
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-019-06634-6