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Imaging of infective endocarditis with cardiac CT angiography

  • Daniel W. Entrikin
    Correspondence
    Corresponding author.
    Affiliations
    Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA

    Department of Internal Medicine, Section on Cardiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA
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  • Pushpender Gupta
    Affiliations
    Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA
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  • Neal D. Kon
    Affiliations
    Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA
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  • J. Jeffrey Carr
    Affiliations
    Department of Radiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA

    Department of Internal Medicine, Section on Cardiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1088, USA
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Published:October 16, 2012DOI:https://doi.org/10.1016/j.jcct.2012.10.001

      Abstract

      Infective endocarditis (IE) is a disease characterized by high rates of morbidity and mortality that can present with a spectrum of clinical and imaging findings. Cardiac-gated computed tomographic angiography (CTA) has been shown to be highly accurate in evaluation of both coronary artery disease and structural heart disease and is now considered an appropriate preoperative imaging modality in patients undergoing noncoronary cardiac surgery. This review discusses the use of cardiac-gated CTA in preoperative evaluation of patients with IE, with emphasis on imaging findings of valvular and perivalvular complications. Topics include technique tips specific to valve imaging with cardiac-gated CTA, potential benefits of cardiac-gated CTA compared with other imaging modalities such as echocardiography, limitations of imaging patients with IE with cardiac-gated CTA, and an overview of potential findings in patients with IE, including vegetations, valve perforations, perivalvular abscesses, perivalvular pseudoaneurysms, and fistulas. Throughout this review, cardiac-gated CTA findings of IE are presented with echocardiographic and operative correlation to emphasize that cardiac-gated CTA may in select cases provide incremental benefit in the preoperative assessment of patients with IE.

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