Abstract
BackgroundSubstantial development of cardiac computed tomography angiography (CTA) technology in the last decade has commanded to increase usage of this modality for assessing infective endocarditis (IE). The objective of this study is to evaluate the sensitivity and specificity of preoperative cardiac CTA imaging as opposed to transthoracic echocardiography (TTE) in the assessment of complications associated to IE, with comparison to surgical findings.MethodsAmong 52 patients with surgically proven IE in our database, 24 underwent contrast-enhanced ECG cardiac CTA and were included in the study and all of them also underwent TTE.ResultsFor the detection of pseudoaneurysm/abscess in both native and prosthetic valves, cardiac CTA demonstrated significantly higher sensitivity (91.5% vs. 15.8%, p < 0.0001) with similar specificity (81.25). Cardiac CTA demonstrated similar sensitivity and specificity in identifying vegetation and valvular dehiscence in all patients.ConclusionsPreoperative cardiac CTA can be seen as complementary to TTE in assessing complications such as pseudoaneurysm or abscess of the patients with IE.
Highlights
The diagnosis of infective endocarditis (IE) is challenging with up to 40% risk of mortality [1]
Cardiac computed tomography angiography (CTA) was similar to transthoracic echocardiography (TTE) in identification of vegetation and dehiscence in the present study, unsurprisingly, cardiac CTA demonstrated significantly higher sensitivity for pseudoaneurysm and abscess
This is regardless of almost one-half of patients having prosthetic valves with current evidence indicating that cardiac CTA has the capability to change diagnosis/treatment with echocardiography in 20–25% of prosthetic IE cases [14]
Summary
The diagnosis of infective endocarditis (IE) is challenging with up to 40% risk of mortality [1]. Transthoracic echocardiography (TTE) is typically the initial imaging study to assess valvular involvement in IE [2]. Cardiac computed tomography angiography (CTA), characteristically plays a supportive role in imaging assessment of complication of IE. Use of this modality for evaluating IE has been increasing. Substantial development of cardiac computed tomography angiography (CTA) technology in the last decade has commanded to increase usage of this modality for assessing infective endocarditis (IE). The objective of this study is to evaluate the sensitivity and specificity of preoperative cardiac CTA imaging as opposed to transthoracic echocardiography (TTE) in the assessment of complications associated to IE, with comparison to surgical findings
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