Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Cardiothoracic Surgery
Published in: Journal of Cardiothoracic Surgery 1/2019

Open Access 01-12-2019 | Transthoracic Echocardiography | Research article

Value of cardiac computed tomography angiography in pre-operative assessment of infective endocarditis

Authors: Narumol Chaosuwannakit, Pattarapong Makarawate

Published in: Journal of Cardiothoracic Surgery | Issue 1/2019

Login to get access

Abstract

Background

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.

Methods

Among 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.

Results

For 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.

Conclusions

Preoperative cardiac CTA can be seen as complementary to TTE in assessing complications such as pseudoaneurysm or abscess of the patients with IE.
Literature
1.
Vincent LL, Otto CM. Infective endocarditis : update on epidermiology, outcomes, and management. Curr Cardiol Rep. 2018;16:74–86.
2.
Thuny F, Grisoli D, Cautela J, Riberi A, Raoult D, Habib G. Infective endocarditis: prevention, diagnosis, and management. Can J Cardiol. 2014;30:1046–57.CrossRef
3.
Li JS, Sexton DJ, Mick N, Nettles R, Fowler VG Jr, Ryan T, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30:633–8.CrossRef
4.
Feuchtner GM, Stolzmann P, Dichtl W, Schertler T, Bonatti J, Scheffel H, et al. Multislice computed tomography in infective endocarditis. comparison with transesophageal echocardiography and intraoperative findings J Am Coll Cardiol. 2009;53:436–44.PubMed
5.
Gahide G, Bommart S, Demaria R, Sportouch C, Dambia H. Albat, et al. preoperative evaluation in aortic endocarditis: findings on cardiac CT. AJR Am J Roentgenol. 2010;194:574–8.CrossRef
6.
Fagman E, Perrotta S, Bech-Hanssen O, Flinck A, Lamnm C, Olaison L, et al. ECG- gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis. Eur Radiol. 2012;22:2407–14.CrossRef
7.
Habets J, Tanis W, van Herwerden LA, van den Brink RB, Mali WP, de Mol BA, et al. Cardiac computed tomography angiography results in diagnostic and therapeutic change in prosthetic heart valve endocarditis. Int J Cardiovasc Imaging. 2014;30:377–87.CrossRef
8.
Sims JR, Anavekar NS, Chandrasekaran K, Steckelberg JM, Wilson WR, Gersh BJ, et al. Utility of cardiac computed tomography scanning in the diagnosis and pre-operative evaluation of patients with infective endocarditis. Int J Cardiovasc Imaging. 2018;34(7):1155–63.CrossRef
9.
Koo HJ, Yang DH, Kang JW, Lee JY, Kim DH, Song JM, et al. Demonstration of infective endocarditis by cardiac CT and transoesophageal echocardiography: comparison with intra-operative findings. Eur Heart J Cardiovasc Imaging. 2018;19:199–207.CrossRef
10.
Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the management of InfectiveEndocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36:3075–128.CrossRef
11.
Fagman E, Flinck A, Snygg-Martin U, Olaison L, Bech-Hanssen O, Svensson G. Surgical decision-making in aortic prosthetic valve endocarditis: the influence of electrocardiogram-gated computed tomography. Eur J Cardiothorac Surg. 2016;50:1165–71.CrossRef
12.
Chaosuwannakit N. Role of dual source multidetector row cardiac computed tomography angiography in diagnosis and management of congenital heart disease patients. Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery. 2017;14(3):180–5.
13.
Sachdev M, Peterson GE, Jollis JG. Imaging techniques for diagnosis of infective endocarditis. Cardiol Clin. 2003;21:185–95.CrossRef
14.
Sudhakar S, Sewani A, Agrawal M, Uretsky BF. Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIVF): a comprehensive review. J Am Soc Echocardiogr. 2010;23:1009–18.CrossRef
15.
Daniel WG, Mugge A, Martin RP, Lindert O, Hausmann D, Nonnast-Daniel B, et al. Improvement in the diagnosis of abscesses associated with endocarditis by transesophageal echocardiography. N Engl J Med. 1991;324:795–800.CrossRef
16.
Afridi I, Apostolidou MA, Saad RM, Zoghbi WA. Pseudoaneurysms of the mitral-aortic intervalvular fibrosa: dynamic characterization using transesophageal echo-cardiographic and Doppler techniques. J Am Coll Cardiol. 1995;25:137–45.CrossRef
17.
Gahide G, Bommart S, Demaria R, Sportouch C, Dambia H, Albat B, et al. Preoperative evaluation in aortic endocarditis: findings on cardiac CT. AJR Am J Roentgenol. 2010;194:574–8.CrossRef
18.
Arbab-Zadeh A, Miller JM, Rochitte CE, Dewey M, Niinuma H, Gottlieb I, et al. Diagnostic accuracy of computed tomography coronary angiography according to pre-test probability of coronary artery disease and severity of coronary arterial calcification. The CORE-64 (coronary artery evaluation using 64-row multidetector computed tomography angiography) international multicenter study. J Am Coll Cardiol. 2012;59(4):379–87.CrossRef
19.
Kalil-Filho R, Vavere AL, Cohn S, Cox C, Brinker J, Miller JM, et al. Accuracy of multidetector computed tomography for detection of coronary artery stenosis in acute coronary. syndrome compared with stable coronary disease: a CORE64 multicenter trial substudy. Int J Cardiol. 2014;177(2):385–91.CrossRef
20.
Cademartiri F, Maffei E, Palumbo A, Seitun S, Martini C, Tedeschi C, et al. Coronary calcium score and computed tomography coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease. Eur Radiol. 2010;20(4):846–54.CrossRef
21.
Jakamy R, Barthelemy O, Le Feuvre C, Berman E, Boutekadjirt R, Cluzel P, et al. Accuracy of multislice computed tomography in the preoperative assessment of coronary disease in patients scheduled for heart valve surgery. Arch Cardiovasc Dis. 2012;105(8–9):424–31.CrossRef
22.
Ciolina F, Sedati P, Zaccagna F, Galea N, Noce V, Miraldi F, et al. Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography. J Cardiovasc Surg. 2015;56(5):799–808.
Metadata
Title
Value of cardiac computed tomography angiography in pre-operative assessment of infective endocarditis
Authors
Narumol Chaosuwannakit
Pattarapong Makarawate
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2019
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-019-0880-4

Other articles of this Issue 1/2019

Journal of Cardiothoracic Surgery 1/2019 Go to the issue

Case report

Repair of a type B aortic dissection with a re-vascularization of the aberrant right subclavian artery in an adult patient

Correction

Correction to: Mitral regurgitation detected during the intraoperative period after atrial septal defect closure: a case report

Case report

The novel use of oral antibiotic monotherapy in prosthetic valve endocarditis caused by Finegoldia magna: a case study

Case report

Thoracic aortic aneurysms exerting high extrinsic pressure on the airway

Research article

Comparison of conventional and primary sutureless surgery for repairing supracardiac total anomalous pulmonary venous drainage

Research article

Recurrent mitral regurgitation after mitral valve repair for bileaflet lesions in the modern era