- Oral presentation
- Open Access
Feasibility to assess the orifice area of mitral bioprostheses using cardiovascular magnetic resonance
© von Knobelsdorff-Brenkenhoff et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
The orifice area of heart valve bioprostheses is important to evaluate their hemodynamic performance. However, its calculation using transthoracic echocardiography (TTE) is frequently complicated due to limited acoustic windows and methodical concerns. Regarding aortic bioprostheses, cardiovascular magnetic resonance (CMR) has recently been established as an alternative tool to assess the orifice area. Yet, in mitral position, annular plane excursion and frequent coincident arrhythmias raise concerns whether CMR can be applied likewise.
We initiated a feasibility series testing CMR to quantify the orifice area of mitral bioprostheses.
In TTE, mean transprosthetic pressure gradients ranged from 3 to 11 mmHg and pressure half time derived prosthetic orifice areas from 1.8 to 2.6 cm2. In CMR, diagnostic image quality was achieved in 100% despite atrial fibrillation in 5 and ventricular extrasystolia in 1 subject. Images are depicted in the table. Manual planimetry offered orifice areas from 1.7 to 2.4 cm2, which agreed well with TTE (r = 0.90; mean difference -0.12 ± 0.12 cm2).
Imaging of mitral bioprostheses using CMR with SSFP sequences is feasible and provides orifice areas with close correlation to echocardiography, even in atrial fibrillation. Larger samples are required to confirm these preliminary results.
This article is published under license to BioMed Central Ltd.