Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis

Prosthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission tomography including...

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Veröffentlicht in:Netherlands heart journal 2016-02, Vol.24 (2), p.96-107
Hauptverfasser: Tanis, W., Budde, R. P. J., van der Bilt, I. A. C., Delemarre, B., Hoohenkerk, G., van Rooden, J.-K., Scholtens, A. M., Habets, J., Chamuleau, S.
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container_end_page 107
container_issue 2
container_start_page 96
container_title Netherlands heart journal
container_volume 24
creator Tanis, W.
Budde, R. P. J.
van der Bilt, I. A. C.
Delemarre, B.
Hoohenkerk, G.
van Rooden, J.-K.
Scholtens, A. M.
Habets, J.
Chamuleau, S.
description Prosthetic heart valve (PHV) dysfunction remains difficult to recognise correctly by two-dimensional (2D) transthoracic and transoesophageal echocardiography (TTE/TEE). ECG-triggered multidetector-row computed tomography (MDCT), 18-fluorine-fluorodesoxyglucose positron emission tomography including low-dose CT (FDG-PET) and three-dimensional transoesophageal echocardiography (3D-TEE) may have additional value. This paper reviews the role of these novel imaging tools in the field of PHV obstruction and endocarditis. For acquired PHV obstruction, MDCT is of additional value in mechanical PHVs to differentiate pannus from thrombus as well as to dynamically study leaflet motion and opening/closing angles. For biological PHV obstruction, additional imaging is not beneficial as it does not change patient management. When performed on top of 2D-TTE/TEE, MDCT has additional value for the detection of both vegetations and pseudoaneurysms/abscesses in PHV endocarditis. FDG-PET has no complementary value for the detection of vegetations; however, it appears more sensitive in the early detection of pseudoaneurysms/abscesses. Furthermore, FDG-PET enables the detection of metastatic and primary extra-cardiac infections. Evidence for the additional value of 3D-TEE is scarce. As clinical implications are major, clinicians should have a low threshold to perform additional MDCT in acquired mechanical PHV obstruction. For suspected PHV endocarditis, both FDG-PET and MDCT have complementary value.
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subjects Abscesses
Antibiotics
Cardiology
Endocarditis
Glucose
Heart
Medical Education
Medicine
Medicine & Public Health
Metabolism
Patients
Prostheses
Pseudoaneurysm
Review
Review Article
Tomography
title Novel imaging strategies for the detection of prosthetic heart valve obstruction and endocarditis
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