MDCT, MRI, TTE, TEE - Important Comparison of Aortic Valve Imaging

[Arlyss]

Another thread has discussed getting CT and MRI scans to image the aorta. The following link is important because it compares the imaging options for studying the aortic valve, specifically measuring the aortic valve area. This is a measurement that gets a lot of attention because it indicates how widely the aortic valve opens.

http://www.ncbi.nlm.nih.gov/sites/e...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

What is very striking in this paper is that there were 14 BAVs in the study group. They were successfully detected by TEE. However, "regular" echo (TTE) through the chest wall missed 8 of the 14 BAVs. MDCT (64 slice CT) also accurately found all 14 BAVs!

I had previously heard that TTE could miss between 20% and 50% of BAVs. This is why it is a problem as a screening test - it misses way too many BAVs. When the valve is considered normal, trileaflet, will anyone look for an ascending aortic aneurysm? Probably not. Someone with BAVD could be sent out to die from an undetected ascending aortic aneurysm because the aortic valve looked fine by TTE. This is why, especially in families where there is a known BAV, a TTE should not be the only test done to look at the aortic valve and the aorta.

Prior to surgery, which is what this paper was addressing, both the person and the surgeon need the very best picture of what is inside to minimize "surprises" once the chest is open.

But there should be no surprises at any time in a BAV person's life - and getting the best possible pictures of what is inside is what helps avoid those surprises!

Best wishes,
Arlyss

 

[Susan BAV]

As per usual, excellent information; thank you Arlyss.

 

[Arlyss]

The ability to "see" and "measure" inside the chest continues to advance, and I am deeply grateful. For those with heart and blood vessel issues, it has opened a whole world of opportunity to be able to accurately picture what is there.

I will just mention again here that a TEE, although more invasive, will do something that none of the other tests listed can do at this time. TEE detects fine hair-like growths on a valve that are called strands. Today we are at the point where these strands are starting to be detected after a stroke has happened. Next we can and should identify those at risk, and do the TEE before the devastation of a stroke happens.

There has been great progress in testing since my husband had his first TTE in 1990. Doing your home work on the kinds of tests that are available today and how they are used to monitor and help you is an important step in dealing with valve and aortic disease. And remember that you can request copies of all the reports and all the images on CD and tape and keep them in your own files. They are a picture of you that is important to have and share with the doctors you work with through out your entire life.

Best wishes,
Arlyss