- 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.
- We present a case of a primary cardiac B-cell lymphoma where a multiphase-gated cardiac CT exam helped to successfully guide trans-sternal needle biopsy to establish a tissue diagnosis.
- A 41-year-old male with prior history of aortic root replacement for infectious endocarditis was found to have a pseudoaneurysm in the fibrous continuity between the aortic and mitral valves: the so called “mitral-aortic intervalvular fibrosa.” Preoperative cardiac-gated computed tomographic angiography and intraoperative transesophageal echocardiography imaging findings used to guide surgical repair are presented.
- A previously healthy 35-year-old man sought treatment for fatigue, malaise, and persistent low-grade fevers. Blood cultures obtained were positive for Streptococcus viridans. Reports from transthoracic (TTE) and transesophageal echocardiography (TEE) performed at an outside institution showed a bicuspid aortic valve with 1-cm vegetations on one of the valve cusps and severe aortic insufficiency. He was referred to our institution for aortic valve replacement, and a cardiac-gated computed tomography angiography (CTA) was performed to assess for coronary artery disease.