Cardiac CT demonstration of perivalvular extension in aortic valve infective endocarditis

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Aortic valve infective endocarditis (n=1). Intervention: Delayed-phase cardiac CT vs. Transesophageal echocardiography. Primary outcome: Detection and characterization of perivalvular abscess.

Q: What does this research mean for the field?

Delayed-phase cardiac CT identifies perivalvular abscesses by depicting a nonenhancing purulent core, serving as an effective diagnostic adjunct to echocardiography in aortic valve infective endocarditis. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Anish Goel; Arzu Canan

doi:10.1007/s10554-026-03842-2

October 17, 2026The International Journal of Cardiovascular ImagingOpen Access

Cardiac CT demonstration of perivalvular extension in aortic valve infective endocarditis

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Key result

Delayed-phase cardiac CT reveals perivalvular abscess extension into the septum causing complete AV block.

n=1

Why the study?

Cardiac CT's adjunctive role to echocardiography in evaluating perivalvular complications of aortic valve infective endocarditis was not fully established.

Does delayed-phase cardiac CT improve the detection and characterization of perivalvular abscesses in patients with infective endocarditis?

Key Points

Illustrate the adjunctive diagnostic utility of delayed-phase cardiac CT for detecting perivalvular extension and complications in aortic valve infective endocarditis.
Evaluated a 70-year-old male presenting with fever, chest pain, and complete third-degree atrioventricular block using transthoracic and transesophageal echocardiography.
Performed retrospectively EKG-gated arterial phase cardiac CT followed 30 s later by prospectively EKG-gated, end-diastolic delayed-phase acquisition.
Delayed-phase cardiac CT demonstrated a 1.5 × 3.0 cm perivalvular abscess with a central nonenhancing purulent core extending into the basal interventricular septum.
Arterial phase CT identified a 0.8 cm subvalvular pseudoaneurysm beneath the noncoronary cusp and ascending aortic dilation up to 5.2 cm.
Intraoperative findings confirmed periaortic abscess extension into the interventricular septum and aortomitral curtain, guiding urgent aortic and mitral valve replacement.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

Does delayed-phase cardiac CT improve the detection and characterization of perivalvular abscesses in patients with infective endocarditis?

P

Population

A 70-year-old man presenting with aortic valve infective endocarditis and third-degree atrioventricular block.

E

Exposure

Retrospectively EKG-gated arterial-phase cardiac CT followed by a prospectively EKG-gated, end-diastolic delayed acquisition 30 seconds after the arterial phase.

C

Comparator

Transthoracic and transesophageal echocardiography (which could not delineate the full extent of the periaortic abnormality).

O

Outcome

Demonstration and characterization of perivalvular extension/abscess.surrogate

Implication

Delayed-phase cardiac CT is a highly useful adjunct to echocardiography in infective endocarditis for clearly depicting perivalvular abscesses and facilitating surgical planning.

Abstract

The International Journal of Cardiovascular Imaging - Delayed-phase cardiac CT depicts perivalvular abscess, demonstrating its adjunctive role to echocardiography in endocarditis evaluation.

Discussion

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Cite This Study

Goel et al. (2026) conducted a case report in Aortic valve infective endocarditis (n=1). Delayed-phase cardiac CT vs. Transesophageal echocardiography was evaluated on Detection and characterization of perivalvular abscess. Delayed-phase cardiac CT successfully demonstrated a perivalvular abscess with a nonenhancing core extending into the interventricular septum, explaining the patient's third-degree AV block.

synapsesocial.com/papers/6ad49f5fcc23993462cc533e https://doi.org/10.1007/s10554-026-03842-2

Topics

Infective endocarditis

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Cardiac CT demonstration of perivalvular extension in aortic valve infective endocarditis

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

Topics

Cardiac CT demonstration of perivalvular extension in aortic valve infective endocarditis

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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