Role of Cardiac CT in the Evaluation of Valvular Heart Disease

Cardiac CT has become an essential imaging modality in the diagnostic and therapeutic workflow for valvular heart disease (VHD), particularly in the era of transcatheter and minimally invasive valve therapies. The existing guidelines emphasize cardiac CT infrastructure and expertise as core requirements for both primary and comprehensive valve centers. Advances in CT acquisition and image reconstruction allow precise evaluation of valvular morphology, motion, and calcification, supporting accurate disease-severity grading and procedural planning. In comparison with echocardiography, cardiac CT provides superior spatial resolution and is less affected by acoustic shadowing from heavy calcification or prosthetic materials, making it especially valuable in complex or inconclusive cases. This review summarizes the CT scanning protocols and reconstruction strategies for valvular assessment and discusses CT-based evaluations of native-valve stenosis and regurgitation, prosthetic-valve dysfunction-including structural degeneration, thrombosis, and pannus-and infective endocarditis, highlighting the complementary role of CT alongside echocardiography in comprehensive VHD management.