Added value of ¹⁸F-FDG-PET/CT and cardiac CTA in suspected transcatheter aortic valve endocarditis.

ABSTRACT:

Backgrounds

Transcatheter-implanted aortic valve infective endocarditis (TAVI-IE) is difficult to diagnose when relying on the Duke Criteria. Our aim was to assess the additional diagnostic value of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission/computed tomography (PET/CT) and cardiac computed tomography angiography (CTA) in suspected TAVI-IE.

Methods

A multicenter retrospective analysis was performed in all patients who underwent ¹⁸F-FDG-PET/CT and/or CTA with suspected TAVI-IE. Patients were first classified with Duke Criteria and after adding ¹⁸F-FDG-PET/CT and CTA, they were classified with European Society of Cardiology (ESC) criteria. The final diagnosis was determined by our Endocarditis Team based on ESC guideline recommendations.

Results

Thirty patients with suspected TAVI-IE were included. ¹⁸F-FDG-PET/CT was performed in all patients and Cardiac CTA in 14/30. Using the Modified Duke Criteria, patients were classified as 3% rejected (1/30), 73% possible (22/30), and 23% definite (7/30) TAVI-IE. Adding ¹⁸F-FDG-PET/CT and CTA supported the reclassification of 10 of the 22 possible cases as "definite TAVI-IE" (5/22) or "rejected TAVI-IE" (5/22). This changed the final diagnosis to 20% rejected (6/30), 40% possible (12/30), and 40% definite (12/30) TAVI-IE.

Conclusions

Addition of ¹⁸F-FDG-PET/CT and/or CTA changed the final diagnosis in 33% of patients and proved to be a valuable diagnostic tool in patients with suspected TAVI-IE.

SUBMITTER: Wahadat AR 

PROVIDER: S-EPMC8648682 | biostudies-literature |

REPOSITORIES: biostudies-literature