The number of patients requiring heart valve surgery continues to increase with the growing life expectancy and expansion of both surgical and transcatheter valves. In patients with prosthetic heart valves (PHV), transthoracic echocardiography is the mainstay for initial assessment and serial surveillance. However, multimodality imaging, including three-dimensional transesophageal echocardiography, cardiac computed tomography, cardiac magnetic resonance, fluoroscopy, and nuclear imaging, is becoming more commonly used clinically to aid in diagnosis and to identify the mechanism of PHV dysfunction. This review aims to provide an updated overview of the use of multimodality imaging in evaluation of PHVs, to illustrate the imaging appearance of different complications, and to highlight a practical approach to help clinical decision making in challenging cases of PHV dysfunction.
Keywords: Hypoattenuating leaflet thickening; Infective endocarditis; Multimodality imaging; Pannus; Paravalvular leak; Paravalvular lesions; Patient prosthesis mismatch; Prosthetic heart valves; Prosthetic valve dysfunction; Prosthetic valve regurgitation; Prosthetic valve stenosis; Reduced leaflet motion; Valve replacement; Valvular degeneration; Valvular dehiscence; Valvular thrombus; Vegetation.
Published by Elsevier Inc.