Complementary role of cardiac computed tomography angiography in the diagnosis of prosthetic aortic valve endocarditis and septic coronary embolism - a case report

Authors

  • Thomas Pieter Willem van den Boogert
  • Bimmer Elisabeth Peter Marie Claessen
  • Danií«lle Robbers-Visser
  • José Paulo Simào Henriques
  • Robrecht Nils Planken

DOI:

https://doi.org/10.3941/jrcr.v13i2.3464

Keywords:

Computed tomography, prosthetic heart valve endocarditis, computed tomography coronary angiography, invasive coronary angiography, prosthetic heart valve, prosthetic valve thrombosis, coronary embolization, transesophageal echocardiography

Abstract

A 73-year old man presented with a posterolateral ST-elevated myocardial infarction 9 months after biological aortic valve replacement for aortic valve stenosis. Invasive coronary angiography showed a filling defect across the left main coronary artery bifurcation extending into the left anterior descending artery and the ramus circumflex. Transthoracic echocardiography revealed a thickened prosthesis leaflet with signs of slight stenosis. Cardiac computed tomography angiography showed a mass on the left coronary cusp of the valve prosthesis, suggestive for vegetation or thrombus. The scan also revealed central luminal filling defects, indicative for thrombus or septic emboli. Blood cultures proved positive for Propionibacterium acnes, therefore the patient was treated for prosthetic valve endocarditis. Computed tomography angiography offers high diagnostic accuracy for detecting infective endocarditis and renders complementary information about valvular anatomy, coronary artery disease and the extension of infections.
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Published

2019-02-22

Issue

Vol. 13 No. 2 (2019)

Section

Cardiac Imaging

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