Key result
Multidetector computed tomography complemented transoesophageal echocardiography by identifying an additional left atrial vegetation and osteomyelitis in a 72-year-old man with fungal endocarditis.
Why the study?
Does multidetector CT provide complementary diagnostic information to transoesophageal echocardiography in the preoperative evaluation of prosthetic valve endocarditis?
Case Report (n=1)
Does multidetector CT provide complementary diagnostic information to transoesophageal echocardiography in the preoperative evaluation of prosthetic valve endocarditis?
MDCT provides valuable complementary information to TEE in evaluating complex prosthetic valve endocarditis, particularly for identifying extra-cardiac complications and hidden vegetations.
MDCT may complement TEE in select fungal endocarditis cases; leaves open its routine preoperative role in prosthetic valve endocarditis.
A 72-year-old man with previous mitral valve replacement and single coronary bypass surgery was diagnosed with recurrent candida endocarditis by transoesophageal echocardiography and positive blood cultures. Preoperative electrocardiogram-gated multidetector CT (MDCT) was ordered to evaluate the patency and course of the mammary graft. In addition to verifying graft patency, MDCT demonstrated a mobile vegetation on the mitral prosthesis as well as a vegetation on the posterior left atrial wall which was not visible by transoesophageal echocardiography. Multidetector CT also revealed signs of osteomyelitis in the thoracic spine. Repeated surgery confirmed these findings and mitral valve replacement with resection of the left atrial vegetation were performed. This case illustrates the complementary role of MDCT and echocardiography in the preoperative evaluation of fungal endocarditis.
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Ghersin et al. (2007) conducted a case report in Candida prosthetic valve endocarditis (n=1). Multidetector computed tomography (MDCT) vs. Transoesophageal echocardiography was evaluated. Multidetector computed tomography complemented transoesophageal echocardiography by identifying an additional left atrial vegetation and osteomyelitis in a 72-year-old man with fungal endocarditis.
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