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

Suyon Chang, Young Joo Suh, Kyunghwa Han, Jin Young Kim, Young Jin Kim, Byoung Wook Choi

Research output: Contribution to journalArticle

3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)344-348
Number of pages5
JournalInternational Journal of Cardiology
Volume249
DOIs
Publication statusPublished - 2017 Dec 15

Fingerprint

Mitral Valve
Tomography
Transesophageal Echocardiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Chang, Suyon ; Suh, Young Joo ; Han, Kyunghwa ; Kim, Jin Young ; Kim, Young Jin ; Choi, Byoung Wook. / The clinical significance of perivalvular pannus in prosthetic mitral valves : Can cardiac CT be helpful?. In: International Journal of Cardiology. 2017 ; Vol. 249. pp. 344-348.
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title = "The clinical significance of perivalvular pannus in prosthetic mitral valves: Can cardiac CT be helpful?",
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.",
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The clinical significance of perivalvular pannus in prosthetic mitral valves : Can cardiac CT be helpful? / Chang, Suyon; Suh, Young Joo; Han, Kyunghwa; Kim, Jin Young; Kim, Young Jin; Choi, Byoung Wook.

In: International Journal of Cardiology, Vol. 249, 15.12.2017, p. 344-348.

Research output: Contribution to journalArticle

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T1 - The clinical significance of perivalvular pannus in prosthetic mitral valves

T2 - Can cardiac CT be helpful?

AU - Chang, Suyon

AU - Suh, Young Joo

AU - Han, Kyunghwa

AU - Kim, Jin Young

AU - Kim, Young Jin

AU - Choi, Byoung Wook

PY - 2017/12/15

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N2 - 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.

AB - 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.

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