Non-Invasive Imaging of Prosthetic Heart Valves with a Focus on Endocarditis

Abstract

Prosthetic heart valve (PHV) implantation can be a life-saving intervention. However, it does provide the patient with a lifelong chronic condition. Prosthetic heart valves can become dysfunctional due to various causes. The most dreaded complication is PHV endocarditis. Patients with a PHV are at higher risk to develop endocarditis because of the exposure of foreign material to the bloodstream. The reported incidence of PHV endocarditis varies considerably in the literature [1], probably because PHV endocarditis is such a difficult diagnosis to establish. The patient can present with a variety of symptoms that are often non-specific. Diagnosis of endocarditis has relied on the Duke criteria, which incorporates findings from echocardiography, physical examination, and blood cultures. The Duke criteria are known to be less accurate in PHV endocarditis [1]. Echocardiography is often hampered by PHV-induced artifacts, and blood cultures are more often negative.