Method of non-destructive analysis of heart valve prostheses based on CT data

Background. Heart valve biopstheses are widely used in the surgical treatment of acquired heart valve defects. However, their main drawback remains progressive structural dysfunction, which requires replacement of up to 50 % of implants after 10–15 years. Modern diagnostic methods are needed to analyze the causes of dysfunction. One of the most promising methods is computed tomography (CT) with subsequent three-dimensional reconstruction of DICOM images, which allows for detailed visualization of the entire prosthesis as a whole, rather than just its individual fragments. Objective. To develop a method for non-destructive analysis of the calcification of biological heart valve prostheses based on computed tomography data. Materials and Methods. Two domestic “UniLine” bioprostheses with similar service lives (4 years 6 months and 5 years 9 months), but different degrees of calcification, were studied. Both prostheses were scanned using a clinical LightSpeed VCT CT scanner. The obtained DICOM images were processed using specially developed algorithms to construct three-dimensional models and calculate the volume of calcifications. Results. The first prosthesis, explanted earlier (after 4 years and 6 months), was significantly more calcified. Its total volume of calcification together with the metal frame was 129.53 mm³. In the second sample (service life 5 years 9 months), a lower calcification volume was recorded — 68.95 mm³ (the volume of the frame itself) — confirming a minimal degree of calcium deposition. Conclusion. The developed CT analysis method has proven effective for non-destructive research into the structural changes of bioprostheses. Nevertheless, there are certain limitations due to the equipment’s resolution and the difficulty of differentiating metal components from calcium deposits. This approach requires further improvement but already represents a valuable tool for the objective assessment of the condition of implanted devices.

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