Diagnosis of Structural Deterioration in an Aortic Bioprosthetic Valve by Multidetector Row Computed Tomography: Report of a Case

A 32-year-old female patient presented with shortness of breath. The patient had received aortic valve replacement with a 25-mm bioprosthetic valve at the age of 22, and had had two babies, postoperatively. Ten years later, echocardiography showed the calcified bioprosthetic valve with a high peak pressure gradient (70 mmHg) and a reduced valve orifice area (0.46 cm(2)). Electrocardiographically gated multidetector row computed tomography (ECG-gated MDCT) clearly demonstrated calcified bioprosthetic cusps with reduced mobility, and the valve orifice area was measured to be 0.64 cm(2) by direct planimetry. These findings observed by ECG-gated MDCT were confirmed at reoperation. This is the first reported reoperation case of aortic structural valve deterioration clearly visualized by ECG-gated MDCT.