Author + information
- Received July 25, 2011
- Accepted August 11, 2011
- Published online May 22, 2012.
- Petr Symersky, MD⁎,
- Ricardo P.J. Budde, MD, PhD†,
- Dave R. Koolbergen, MD, PhD⁎ and
- Bas A.J.M. de Mol, MD, PhD⁎
A 51-year-old woman who had undergone aortic, mitral, and tricuspid replacement 9 years previously was admitted for aortic prosthetic obstruction, degeneration of the tricuspid bioprosthesis, and severe pulmonary regurgitation. A pre-operative electrocardiography-gated computed tomography (CT) scan (Philips iCT, Cleveland, Ohio) demonstrated subprosthetic tissue under the aortic prosthesis (A and B, arrows) that was confirmed at surgery (C). Mechanical prostheses were placed in the aortic, tricuspid, and pulmonary positions. After surgery, a residual gradient was found over the aortic valve that was evaluated with a second CT scan. A tilted position of the prosthesis in relation to the left ventricular outflow tract (D and E) was found without obstructive masses and with normal leaflet motion. The other valves functioned normally (F and G,Online Videos 1 and 2). CT imaging helps plan the re-entry strategy for repeat surgery, but also may uncover obstructive valvular masses and abnormal anatomic features as morphological correlates of echocardiographic findings.
- Received July 25, 2011.
- Accepted August 11, 2011.
- American College of Cardiology Foundation