Cardiac computed tomography in the contemporary evaluation of infective endocarditisIncreasing data have accumulated on the role of Cardiac Computed Tomography (CCT) in infective endocarditis (IE) with high accuracy for large vegetations, perivalvular complications and for exclusion of coronary artery disease to avoid invasive angiography. CCT can further help to clarify the etiology of infective prosthetic valve dysfunction (e.g. malposition, abscess, leak, vegetation or mass). Structural interventions have increased the relevance of CCT in valvular heart disease and have amplified its use.
Diagnostic performance of cardiac computed tomography versus transesophageal echocardiography in infective endocarditis: A contemporary comparative meta-analysisCondensed abstract Data regarding the comparison of diagnostic accuracy of TEE and CCT for diagnosing IE are limited. The present meta-analysis compares the diagnostic performance of the two imaging modalities for a variety of complications of IE in the same patient populations. Our results show that both TEE and CCT have good diagnostic accuracy, with TEE showing superiority in detecting leaflet defects and CCT performing better in prosthetic valve endocarditis. CCT also showed a trend towards higher sensitivity than TEE for detection of periannular complications. These findings suggest that CCT is a useful adjunct to TEE for IE, whenever appropriate use of complementary imaging modalities is warranted.
Cardiopulmonary manifestations of isolated pulmonary valve infective endocarditis demonstrated with cardiac CTRight-sided infective endocarditis involving the pulmonary valve is rare. This pictorial essay discusses the use and findings of cardiac CT combined with delayed chest CT and noncontrast chest CT of pulmonary valve endocarditis. Cardiac CT is able to show the full spectrum of right-sided endocarditis cardiopulmonary features including manifestations that cannot be demonstrated by echocardiography.
Expanding pseudoaneurysm compressing the coronary arteries and causing cardiogenic shockA 37-year-old man who recently underwent aortic valve replacement after endocarditis presented with cardiogenic shock. A large expansile pseudoaneurysm was subsequently discovered using multiple imaging modalities. Although transesophageal echocardiography is important in diagnosing valve endocarditis, coronary CT angiography of prosthetic valves is feasible and image quality is good. In this case, coronary CT angiography allowed for better understanding of transesophageal echocardiography images and earlier diagnosis of coronary involvement as cause for left ventricular dysfunction.
Imaging of infective endocarditis with cardiac CT angiographyInfective 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.