Key result
Computed tomography angiography successfully identified a 1.5-cm vegetation at the left ventricular outflow tract in a patient with prosthetic valve endocarditis missed by repeated transesophageal echocardiography.
Case Report (n=1)
Computed tomography angiography can be a crucial diagnostic tool for prosthetic valve endocarditis when transesophageal echocardiography is repeatedly negative.
May support adjunctive CTA when TEE is repeatedly negative in prosthetic valve endocarditis; leaves open prospective validation of diagnostic algorithms.
A 58-year-old man with multiple myeloma, prior bioprosthetic valve, spinal hardware and multiple episodes of Corynebacterium amycolatum bacteremia was found to have a well-seated valve without vegetations, paravalvular leak, abscess or degeneration over a period of 6 months on five separate transesophageal echocardiographic studies. Computed tomography angiography was performed which revealed vegetation at the level of the left ventricular outflow tract. Reoperative sternotomy and interrogation of the valve confirmed a 1.5-cm vegetation with the same bacterium. The patient underwent a redo aortic valve replacement and recovered without any complications. He has been asymptomatic and culture negative on surveillance.
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Aranda‐Michel et al. (2019) conducted a case report in Prosthetic valve endocarditis (n=1). Computed tomography angiography vs. Transesophageal echocardiography was evaluated on Detection of vegetation. Computed tomography angiography successfully identified a 1.5-cm vegetation at the left ventricular outflow tract in a patient with prosthetic valve endocarditis missed by repeated transesophageal echocardiography.
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