Abstract
A 73-year old man presented with a posterolateral ST-elevated myocardial infarction 9 months after biological aortic valve replacement for aortic valve stenosis. Invasive coronary angiography showed a filling defect across the left main coronary artery bifurcation extending into the left anterior descending artery and the ramus circumflex. Transthoracic echocardiography revealed a thickened prosthesis leaflet with signs of slight stenosis. Cardiac computed tomography angiography showed a mass on the left coronary cusp of the valve prosthesis, suggestive for vegetation or thrombus. The scan also revealed central luminal filling defects, indicative for thrombus or septic emboli. Blood cultures proved positive for Propionibacterium acnes, therefore the patient was treated for prosthetic valve endocarditis. Computed tomography angiography offers high diagnostic accuracy for detecting infective endocarditis and renders complementary information about valvular anatomy, coronary artery disease and the extension of infections.
Original language | English |
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Pages (from-to) | 9-14 |
Number of pages | 6 |
Journal | Journal of radiology case reports |
Volume | 13 |
Issue number | 2 |
DOIs | |
Publication status | Published - Feb 2019 |
Keywords
- Aged
- Aortic Valve
- Computed Tomography Angiography
- Coronary Angiography
- Coronary Artery Disease/diagnostic imaging
- Echocardiography
- Embolism/diagnostic imaging
- Endocarditis, Bacterial/diagnostic imaging
- Gram-Positive Bacterial Infections/diagnostic imaging
- Heart Valve Prosthesis/adverse effects
- Humans
- Male
- Propionibacterium acnes
- Prosthesis-Related Infections/diagnostic imaging
- Tomography, X-Ray Computed