Abstract
Bioprosthetic valve thrombosis was previously considered to be a relatively rare complication of surgical or transcatheter bioprosthetic valve replacement. Although echo-cardiograms can reliably show the characteristic findings of prosthetic valve stenosis, differentiating between thrombus formation and pannus overgrowth as the underlying cause of prosthetic valve dysfunction can be challenging. We present the case of a 75-year-old man who underwent transthoracic Doppler echocardiography in the presence of an elevated valvular gradient 2 years after his aortic valve had been surgically replaced with a bioprosthesis. The echocardiographic findings suggested prosthetic valve stenosis. Cardiac computed tomography, performed to distinguish between thrombus formation and pannus overgrowth, revealed hypoattenuated leaflet thickening and reduced leaflet mobility, which suggested thrombus. After the patient took oral anticoagulants for 3 months, images showed complete resolution of the previous abnormalities, thus confirming the diagnosis of bioprosthetic valve thrombosis. We found cardiac computed tomography valuable when evaluating our patient who had an elevated prosthetic valve gradient.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 219-221 |
| Number of pages | 3 |
| Journal | Texas Heart Institute Journal |
| Volume | 46 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 2019 |
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Keywords
- Bioprosthesis/ adverse effects
- Heart valve diseases/diagnostic imaging/ etiology
- Heart valve prosthesis implantation/adverse effects
- Prosthesis failure
- Thrombosis/etiology/preven-tion & control/therapy
- Treatment outcome
PubMed: MeSH publication types
- Case Reports
Cite this
Use of computed tomography to distinguish thrombus from pannus on a bioprosthetic aortic valve. / Kealhofer, Jessica V.; Markowitz, Jeremy S.; Nijjar, Prabhjot S.
In: Texas Heart Institute Journal, Vol. 46, No. 3, 06.2019, p. 219-221.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of computed tomography to distinguish thrombus from pannus on a bioprosthetic aortic valve
AU - Kealhofer, Jessica V.
AU - Markowitz, Jeremy S.
AU - Nijjar, Prabhjot S.
PY - 2019/6
Y1 - 2019/6
N2 - Bioprosthetic valve thrombosis was previously considered to be a relatively rare complication of surgical or transcatheter bioprosthetic valve replacement. Although echo-cardiograms can reliably show the characteristic findings of prosthetic valve stenosis, differentiating between thrombus formation and pannus overgrowth as the underlying cause of prosthetic valve dysfunction can be challenging. We present the case of a 75-year-old man who underwent transthoracic Doppler echocardiography in the presence of an elevated valvular gradient 2 years after his aortic valve had been surgically replaced with a bioprosthesis. The echocardiographic findings suggested prosthetic valve stenosis. Cardiac computed tomography, performed to distinguish between thrombus formation and pannus overgrowth, revealed hypoattenuated leaflet thickening and reduced leaflet mobility, which suggested thrombus. After the patient took oral anticoagulants for 3 months, images showed complete resolution of the previous abnormalities, thus confirming the diagnosis of bioprosthetic valve thrombosis. We found cardiac computed tomography valuable when evaluating our patient who had an elevated prosthetic valve gradient.
AB - Bioprosthetic valve thrombosis was previously considered to be a relatively rare complication of surgical or transcatheter bioprosthetic valve replacement. Although echo-cardiograms can reliably show the characteristic findings of prosthetic valve stenosis, differentiating between thrombus formation and pannus overgrowth as the underlying cause of prosthetic valve dysfunction can be challenging. We present the case of a 75-year-old man who underwent transthoracic Doppler echocardiography in the presence of an elevated valvular gradient 2 years after his aortic valve had been surgically replaced with a bioprosthesis. The echocardiographic findings suggested prosthetic valve stenosis. Cardiac computed tomography, performed to distinguish between thrombus formation and pannus overgrowth, revealed hypoattenuated leaflet thickening and reduced leaflet mobility, which suggested thrombus. After the patient took oral anticoagulants for 3 months, images showed complete resolution of the previous abnormalities, thus confirming the diagnosis of bioprosthetic valve thrombosis. We found cardiac computed tomography valuable when evaluating our patient who had an elevated prosthetic valve gradient.
KW - Bioprosthesis/ adverse effects
KW - Heart valve diseases/diagnostic imaging/ etiology
KW - Heart valve prosthesis implantation/adverse effects
KW - Prosthesis failure
KW - Thrombosis/etiology/preven-tion & control/therapy
KW - Treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=85074439430&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85074439430&partnerID=8YFLogxK
U2 - 10.14503/THIJ-17-6459
DO - 10.14503/THIJ-17-6459
M3 - Article
C2 - 31708708
AN - SCOPUS:85074439430
VL - 46
SP - 219
EP - 221
JO - Texas Heart Institute Journal
JF - Texas Heart Institute Journal
SN - 0730-2347
IS - 3
ER -