Diagnosis of aortic valvular stenosis by multislice cardiac computed tomography.

AIMS: Current improvements in spatial, temporal, and contrast resolution of multislice computed tomography (CT) could be useful in the assessment of valvular diseases. We evaluated the diagnostic accuracy of multislice CT for the identification and quantification of aortic valvular stenosis (AS), compared with echography. METHODS AND RESULTS: Consecutive patients, referred for coronary CT, were evaluated for AS, by the use of standard electrocardiography-gated 16-slice CT protocol. Multiplanar reformat was applied to systolic phases of the cardiac cycle, with projection on thick slices for measuring the aortic valvular area (AVA). CT results were compared with echocardiographic-based measurement of the AVA. Among 107 enrolled patients, CT analysis of the AVA was feasible in 103. Among the 30 patients with AS, Bland-Altman analysis showed good agreement between the two methods [mean difference -7 mm(2) (-40-25 mm(2))]. CONCLUSION: CT analysis of aortic valve is feasible in most cases and allows for reliable diagnosis and quantification of AS.

Interesse da ecocardiografia Doppler na avaliaçäo de próteses valvulares cardíacas: apresentaçäo de 2 casos / Interest of Doppler echocardiography in the evaluation of heart valve prosthesis: report of 2 cases

Säo apresentados dois casos de pacientes portadores de próteses mecânicas: um com prótese de Starr-Edwards de disco, em posiçäo mitral, e outro com prótese de Starr-Edwards de bola em localizaçäo aórtica. Os casos foram seguidos, durante 3 anos, no Serviço de Exploraçäo Funcional do Hospital Raincy de Paris, com emprego da ecocardiografia-Doppler. No caso da prótese mitral, o eco-Doppler permitiu o diagnóstico diferencial dos sopros diastólicos da obstruçäo mitral e insuficiência aórtica; no caso da prótese em localizaçäo aórtica permitiu análise qualitativa da regurgitaçäo e semiquantificaçäo do refluxo valvar