Author + information
- Jason Sims,
- Nandan Anavekar,
- Krishnaswamy Chandrasekaran,
- James Steckelberg,
- Walter Wilson,
- Bernard Gersh,
- Larry Baddour and
- Daniel DeSimone
Background: Transesophageal echocardiography (TEE) is the gold standard imaging test for infective endocarditis (IE). Cardiac computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique. It has shown promise in small non-randomized studies for evaluation of infective endocarditis and has well-studied negative predictive value for coronary artery disease (CAD) in low to intermediate-risk patient populations. The current investigation evaluated the diagnostic utility of cardiac CTA in IE compared with TEE and also compared peri-operative outcomes between patients who underwent cardiac CTA versus invasive coronary angiography (ICA) for assessment of the coronary arteries prior to surgery for IE.
Methods: 255 adults who underwent surgery for IE at Mayo Clinic Rochester between January 1, 2006 and June 1, 2014 were identified retrospectively. 251 patients underwent TEE and 34 patients underwent cardiac CTA.
Results: TEE had statistically higher sensitivity for detection of vegetations (95.6% vs. 70.0%, p<0.0001) and leaflet perforations (81.3% vs. 42.9%, p=0.02). There were no significant differences in sensitivity or specificity for remaining endocarditic lesions. For detection of abscess/pseudoaneurysm there was a non-significant trend towards higher sensitivity of cardiac CTA (90.5% vs. 78.4%, p=0.21). No differences were noted in peri-operative outcomes whether coronary arteries were evaluated by CTA or ICA.
Conclusions: Cardiac CTA was similar to TEE for detection of IE associated abscess/pseudoaneurysm with a non-statistically significant trend toward superiority. This combined with the ability to reliably exclude CAD in low/intermediate risk patients makes cardiac CTA a versatile imaging study in the evaluation of patients with IE.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Non Invasive Imaging: Applications in Novel Disease States and Clinical Scenarios
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1117-200
- 2017 American College of Cardiology Foundation