Technique |
Advantages |
Disadvantage |
TTE |
Non-invasive method that provides evaluation on prosthetic valve
function. |
Limited by acoustic shadowing and artifact from the
prosthetic valve leading to sometimes poor grading of severity and
aetiology differentiation. |
|
Can provide volumetric quantitation. |
It may be unfeasible to use
colour Doppler in imaging paravalvular regurgitation |
|
It is cheaper as it requires less costly resources. |
2D and 3D image
resolution is lower. |
TOE |
Accurately determines the severity, mechanism, and location of the
PVL. |
Limited by acoustic shadowing and artifact from the prosthetic
valve. |
|
Best imaging method to visualise prosthetic valve tears. |
Requires
trained physicians, patient sedation and mechanical
ventilation. |
|
|
Invasive and therefore may cause injury to the
oesophagus. |
Cardiac CT |
Can be used preoperatively to identify the size and shape
of the annulus and calcification degree to reduce the risk of developing
PVL. |
An intravenous contrast is needed to see an image which can be
nephrotoxic. |
|
|
The patient is exposed to radiation whilst undergoing the
scan. |
|
|
Tachycardiac patients have poor temporal resolution. |
Cardiac MRI |
It can be used in patients with both mechanical and
prosthetic valves. |
Can overestimate the severity of the
PVL. |
|
The images obtained have good quality. |
Assessment accuracy can be
affected by tachyarrhythmias. |
|
There is non-need for the use contrasting agents. |
Poor imaging
received with mechanical valve. |