Expanding utility of cardiac computed tomography in infective endocarditis: A contemporary review

Abstract

There is increasing evidence on the utility of cardiac computed tomography (CCT) in infective endocarditis (IE) to investigate the valvular pathology, the extra-cardiac manifestations of IE and pre-operative planning. CCT can assist in the diagnosis of perivalvular complications, such as pseudoaneurysms and abscesses, and can help identify embolic events to the lungs or systemic vasculature. CCT has also been shown to be beneficial in the pre-operative planning of patients by delineating the coronary artery anatomy and the major cardiovascular structures in relation to the sternum. Finally, hybrid nuclear/computed tomography techniques have been shown to increase the diagnostic accuracy in prosthetic valve endocarditis. This manuscript aims to provide a contemporary update of the existing evidence base for the use of CCT in IE.

Angina pectoris? Fake news: a case report of infective endocarditis with giant aortic root abscess detected by cardiac magnetic resonance imaging

“… 6 , 7 The 2020 American College of Cardiology/American Heart Association for the management of patients with valvular heart disease recommended the use of CCT as a complementary imaging modality for IE, and the 2023 ESC guidelines for the management of IE ranked CCT even as a class 1b recommendation in confirming IE diagnosis in patients with possible native valve endocarditis. 1 , 6 , 8 Additionally, patients with elevated hsT levels (>14 ng/L), and inconclusive ECG could be saved by an ICA by upfront imaging with CT of the coronary artery (CTCA) to rule out CAD in suspected CAD, 9 which might also reduce the risk of germ dissemination from vegetations.…”