Diagnostic dilemma in prosthetic valve endocarditis: Computed tomography to the rescue.
Edgar Aranda-MichelArman KilicThomas G GleasonValentino BiancoIbrahim S SultanPublished in: Journal of cardiac surgery (2019)
A 58-year-old man with multiple myeloma, prior bioprosthetic valve, spinal hardware and multiple episodes of Corynebacterium amycolatum bacteremia was found to have a well-seated valve without vegetations, paravalvular leak, abscess or degeneration over a period of 6 months on five separate transesophageal echocardiographic studies. Computed tomography angiography was performed which revealed vegetation at the level of the left ventricular outflow tract. Reoperative sternotomy and interrogation of the valve confirmed a 1.5-cm vegetation with the same bacterium. The patient underwent a redo aortic valve replacement and recovered without any complications. He has been asymptomatic and culture negative on surveillance.
Keyphrases
- aortic valve replacement
- aortic stenosis
- aortic valve
- transcatheter aortic valve replacement
- left ventricular
- transcatheter aortic valve implantation
- ejection fraction
- mitral valve
- computed tomography
- climate change
- multiple myeloma
- coronary artery disease
- left atrial
- spinal cord
- hypertrophic cardiomyopathy
- acute myocardial infarction
- cardiac resynchronization therapy
- coronary artery
- public health
- magnetic resonance imaging
- spinal cord injury
- risk factors
- percutaneous coronary intervention
- gram negative
- atrial fibrillation
- contrast enhanced
- multidrug resistant