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  • Multiphase TAVR CT identifies unexpected sticky situation (Mechanical mitral valve leaflet dysfunction and bicuspid aortic valve)

    Author(s)
    Dahiya, A
    Coucher, J
    Pratap, J
    Cole, C
    Griffith University Author(s)
    Dahiya, Arun
    Year published
    2020
    Metadata
    Show full item record
    Abstract
    60-year-old female with history of 33mm ATS mechanical mitral valve replacement 16 years ago for rheumatic mitral valve disease and permanent Atrial Fibrillation (AF) presented with one-year history of worsening exertional dyspnoea as well as symptom of pre-syncope. She was on warfarin for AF as well as mechanical mitral valve replacement (MVR) with therapeutic anticoagulation in the recent time. Her transthoracic echocardiogram was technically difficult as MVR leaflet motion and aortic valve morphology was not well visualised because of artefact from mechanical mitral valve (Panel 1 A: 4chamber still echo image showing ...
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    60-year-old female with history of 33mm ATS mechanical mitral valve replacement 16 years ago for rheumatic mitral valve disease and permanent Atrial Fibrillation (AF) presented with one-year history of worsening exertional dyspnoea as well as symptom of pre-syncope. She was on warfarin for AF as well as mechanical mitral valve replacement (MVR) with therapeutic anticoagulation in the recent time. Her transthoracic echocardiogram was technically difficult as MVR leaflet motion and aortic valve morphology was not well visualised because of artefact from mechanical mitral valve (Panel 1 A: 4chamber still echo image showing reverberation artefact from mechanical mitral valve leaflets)) and aortic valve calcification. Doppler Echocardiography revealed significant aortic stenosis (AS) and mildly elevated gradients across the MVR with average peak (17 ​mmHg)/mean (6.5 ​mmHg) gradients and Effective Orifice Area (ERO) of 1.9cm2 (normal >2 cm2) at heart rate of 60bpm in AF raising a possibility of only mild mechanical prosthetic mitral valve stenosis.
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    Journal Title
    Journal of Cardiovascular Computed Tomography
    DOI
    https://doi.org/10.1016/j.jcct.2020.11.006
    Note
    This publication has been entered as an advanced online version in Griffith Research Online.
    Subject
    Cardiorespiratory Medicine and Haematology
    Clinical Sciences
    Bicuspid aortic valve
    Mechanical prosthetic valve dysfunction
    Multiphase TAVR CT
    Pannus
    Publication URI
    http://hdl.handle.net/10072/400628
    Collection
    • Journal articles

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