XXXX after Aortic Valve Replacement Surgery: Cardiac CT Findings and Clinical Features.

@entity1 @entity2070 @entity299
UNASSIGNED: Purpose To investigate the cardiac computed tomographic (CT) findings and clinical implications of @entity2070 in @entity1 who have undergone aortic valve replacement. Materials and Methods The institutional review board approved this retrospective study, and the need to obtain written informed consent was waived. From April 2011 to March 2012, 88 @entity1 (mean age, 63 years; 45 @entity1 ) with a prosthetic aortic valve who underwent @entity299 were retrospectively selected. Dynamic @entity299 images were analyzed by using a multiplanar reformatted technique. The presence or absence of @entity2070 and its extent were evaluated at @entity299 . The geometric orifice area and the effective orifice area of each prosthetic valve were measured to enable analysis of the @entity2070 encroachment ratio in the systolic phase. Hemodynamic parameters at echocardiography, including mean transprosthetic pressure gradient (MTPG), were compared between @entity1 with and those without @entity2070 . The encroachment ratio and the MTPG were correlated by using the Spearman test to evaluate the relationship between the two variables. Results Seventeen @entity1 (19%) had @entity2070 at @entity299 . In @entity1 with @entity2070 , MTPG, peak pressure gradient, transvalvular peak velocity, and left ventricular ejection fraction (LVEF) were significantly higher than in @entity1 without @entity2070 (MTPG: 28.1 mm Hg    19.8 [standard deviation] vs 14.0 mm Hg    6.5, P = .004; peak pressure gradient: 53.1 mm Hg    38.4 vs 26.1 mm Hg    11.4, P = .004; transvalvular peak velocity: 3.3 m/sec    1.3 vs 2.5 m/sec    0.5; and LVEF: 64.7%    7.4 vs 56.8%    10.5, P = .004). A high MTPG (>= 40 mm Hg) was observed in four @entity1 at echocardiography, and subprosthetic panni were identified at CT in all four @entity1 . In @entity1 with increased MTPGs, the encroachment ratio by @entity2070 at CT was significantly higher than that in @entity1 with MTPGs of less than 40 mm Hg (42.7    13.3 vs 7.6    3, P = .012). Conclusion Cardiac CT revealed @entity2070 to be a cause of the hemodynamic changes in @entity1 who had undergone aortic valve replacement. By helping quantify the encroachment ratio by @entity2070 , @entity299 may help differentiate which subprosthetic panni might lead to substantial flow limitation over the prosthetic aortic valve. (  ) RSNA, 2015.
