Diagnostic dilemma in prosthetic valve endocarditis: Computed tomography to the rescue

Journal of Cardiac Surgery
Edgar Aranda-MichelIbrahim Sultan

Abstract

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.

References

Feb 8, 2007·BMC Infectious Diseases·Jaime BelmaresJorge P Parada
Jan 9, 2016·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·W TanisS Chamuleau
Nov 17, 2017·Journal of Cardiac Surgery·Ibrahim SultanPrashanth Vallabhajosyula
Feb 3, 2018·The Annals of Thoracic Surgery·Ibrahim SultanNimesh D Desai
Oct 5, 2018·The Journal of Thoracic and Cardiovascular Surgery·Ibrahim SultanThomas G Gleason

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