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Computed tomography reference dimensions for identification of stented surgical mitral bioprostheses valve size

  • Georgios Tzimas
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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  • Delaney Haugan
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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  • Mariama Akodad
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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  • Janarthanan Sathananthan
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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  • David Meier
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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  • Salah Dine Qanadli
    Affiliations
    Department of Radiology, University of Lausanne, Lausanne, Switzerland
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  • John G. Webb
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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  • Philipp Blanke
    Correspondence
    Corresponding author. Department of Radiology, St. Paul's Hospital and University of British Columbia, 1081 Burrard St., Vancouver, BC, V6Z1Y6, Canada
    Affiliations
    Centre for Cardiovascular Innovation and Center for Heart Valve Innovation, St Paul's and Vancouver General Hospital, Division of Cardiology and Department of Radiology University of British Columbia, Vancouver, BC, Canada
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      Abstract

      Background

      Selection of the transcatheter heart valve size for a mitral valve-in-valve procedure is based on the type and manufacturer’s labelled size. However, accurate information of surgical heart valve (SHV) size may not be available in the patient’s medical record. The purpose of this study is to establish reference data for computed tomography (CT) dimensions of commonly used mitral SHV in order to determine the manufacturer’s labelled size from a cardiac CT data set.

      Methods

      CT datasets of 105 patients with surgical mitral bioprosthesis and available manufacturer labeled datasets were included in the analysis. CT derived valve dimensions were assessed by two observers using multiplanar reformats aligned with the basal sewing ring. A circular region of interest was used in a standardized fashion to minimize influence of image acquisition and reconstruction parameters. Interobserver variability was assessed by Bland-Altman analysis.

      Results

      The CT-derived dimensions were stratified by valve size and type, and SHV properties were demonstrated for 5 common valve types. Variability of measurements was small and inter-observer limits of agreement were narrow. Stratified by SHV type, no overlap was noted for CT-derived dimensions among different SHV sizes . A reference table of CT characteristics of surgical mitral bioprosthesis types was created.

      Conclusion

      The study provides reference CT data for determining the manufacturers’ labeled SHV size across a range of commonly used mitral SHVs. The findings will be important to help identify types of surgical mitral bioprosthesis utilizing CT characteristics for patients without SHV size documentation.

      Keywords

      Abbreviations:

      mVIV (Mitral valve in valve), SHV (Surgical Heart Valve), THV (Transcatheter heart valve), CT (Computed Tomography), LVOT (Left Ventricular Outflow Tract)
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