Evaluation of failed prosthetic valves in the valve-in-valve era: Potential for utilizing positron emission tomography/computed tomography to recognize infective endocarditis.
David H LamMalak ItaniDanny DvirPublished in: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2019)
Bioprosthetic valve dysfunction was treated in the past with redo open heart surgery. The need to identify occult leaflet infection was not an important requirement as all valve tissue was removed during surgery. With the dramatic growth in transcatheter aortic valve replacement (TAVR) valve-in-valve (ViV) therapy, identification of occult infection is of major significance. TAVR should be rarely performed in infected prosthetic valves and the optimal approach should include open heart surgery and removal of infected tissue. With surgical implants, it can be challenging to distinguish infection from degeneration. The use of advanced imaging modalities, including 18F-fluorodeoxyglucose positron emission tomography/computed tomography, in the diagnosis of occult infection is emerging. We report the use of this imaging modality to identify or exclude endocarditis in patients with prosthetic valves who were candidates for ViV therapy.
Keyphrases
- aortic valve
- positron emission tomography
- transcatheter aortic valve replacement
- computed tomography
- aortic stenosis
- aortic valve replacement
- minimally invasive
- transcatheter aortic valve implantation
- coronary artery bypass
- mitral valve
- pet imaging
- pet ct
- magnetic resonance imaging
- heart failure
- high resolution
- left ventricular
- dual energy
- oxidative stress
- stem cells
- magnetic resonance
- surgical site infection
- risk assessment
- newly diagnosed
- human health