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Open Access 01-07-2015 | Cardiac

Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis

Authors: Jesse Habets, Wilco Tanis, Johannes B. Reitsma, Renee B. A. van den Brink, Willem P. Th. M. Mali, Steven A. J. Chamuleau, Ricardo P. J. Budde

Published in: European Radiology | Issue 7/2015

Abstract

Objectives

Multimodal non-invasive imaging plays a key role in establishing a diagnosis of PHV endocarditis. The objective of this study was to provide a systematic review of the literature and meta-analysis of the diagnostic accuracy of TTE, TEE, and MDCT in patients with (suspected) PHV endocarditis.

Methods

Studies published between 1985 and 2013 were identified via search and cross-reference of PubMed/Embase databases. Studies were included if (1) they reported on the non-invasive index tests TTE, TEE, or MDCT; (2) data was provided on PHV endocarditis as the condition of interest; and (3) imaging results were verified against either surgical inspection/autopsy or clinical follow-up reference standards, thereby enabling the extraction of 2-by-2 tables.

Results

Twenty articles (including 496 patients) met the inclusion criteria for PHV endocarditis. TTE, TEE, and MDCT + TEE had a pooled sensitivity/specificity for vegetations of 29/100 %; 82/95 %, and 88/94 %, respectively. The pooled sensitivity/specificity of TTE, TEE, and MDCT + TEE for periannular complications was 36/93 %, 86/98 %, and 100/94 %, respectively.

Conclusions

TEE showed good sensitivity and specificity for establishing a diagnosis of PHV endocarditis. Although MDCT data are limited, this review showed that MDCT in addition to TEE may improve sensitivity in detecting life-threatening periannular complications.

Key Points

• Multimodal imaging is an important ingredient of diagnostic workup for PHV endocarditis.

• Transthoracic and transesophageal echography may miss life-threatening periannular complications.

• MDCT can improve sensitivity for the detection of life-threatening periannular complications.

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Title: Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis
Authors: Jesse Habets
Wilco Tanis
Johannes B. Reitsma
Renee B. A. van den Brink
Willem P. Th. M. Mali
Steven A. J. Chamuleau
Ricardo P. J. Budde
Publication date: 01-07-2015
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 7/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3605-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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