Cardiologists, radiologists and surgeons share ‘landmark’ document on assessing prosthetic heart valves with CT
Cardiac CT can provide significant value as a tool for evaluating the function of prosthetic heart valves (PHVs), according to a new consensus document from the Radiological Society of North America (RSNA) and several other medical societies.
Echocardiography remains an effective first-line imaging option, the authors noted, but cardiac CT can provide additional information that improves patient care in a variety of ways.
PHVs, sometimes referred to as artificial heart valves, include the mechanical and biologic valves used during transcatheter aortic valve replacement, surgical aortic valve replacement, transcatheter mitral valve replacement, surgical mitral valve replacement and other related structural heart treatments. Today’s PHVs typically feature a bileaflet design, but older models that clinicians may still encounter featured “tilting disc” or “ball and cage” designs. These valves have been a game-changer for patient care, adding many healthy years to the lives of patient after patient, but they do still grow old or dysfunctional and require an imaging evaluation.
An Evolut TAVR valve from Medtronic (left) and a Sapien 3 TAVR valve from Edwards Lifesciences (right).
The new consensus statement represents a collaboration of RSNA, the American College of Cardiology, the European Society of Cardiovascular Radiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography & Interventions, the Society of Cardiovascular Computed Tomography and the Society of Thoracic Surgeons. It was published in full in Radiology: Cardiothoracic Imaging, the Journal of Cardiovascular Computed Tomography and the Journal of the American College of Cardiology.[1, 2, 3]
“This expert consensus reflects a landmark collaboration among radiologists, cardiologists and cardiac surgeons to standardize the use of cardiac CT in evaluating prosthetic heart valve dysfunction,” explained Suhny Abbara, MD, co-chair of the consensus document and a senior associate consultant and chair of the division cardiothoracic imaging at Mayo Clinic in Jacksonville, Florida. “With major advances in valve technologies, surgical techniques, CT imaging and clinical evidence over the past two decades, this document offers practical, evidence-based guidance to standardize utilization and to improve diagnostic accuracy, reporting consistency and patient outcomes.”
The document’s authors noted that there is still a relatively limited amount of data on the use of cardiac CT to evaluate PHV function. Their hope is that this guidance can help cardiac imagers, cardiologists, surgeons and other clinicians learn more about this topic and feel more confident in cardiac CT’s abilities.
Imaging protocols, radiation exposure, contrast injections, image analysis and postprocessing, heart valve positioning and PHV dysfunction are just some of the topics covered in this in-depth document.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.