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Evaluation of failed prosthetic valves in the valve‐in‐valve era: Potential for utilizing positron emission tomography/computed tomography to recognize infective endocarditis
Author(s) -
Lam David H.,
Itani Malak,
Dvir Danny
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28185
Subject(s) - medicine , occult , infective endocarditis , positron emission tomography , endocarditis , valve replacement , heart valve , radiology , computed tomography , aortic valve , surgery , pathology , stenosis , alternative medicine
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.