Value of cardiac computed tomography angiography in pre-operative assessment of infective endocarditis

Substantial development of cardiac computed tomography angiography (CTA) technology in the last decade has commanded to increase usage of this modality for assessing infective endocarditis (IE). The objective of this study is to evaluate the sensitivity and specificity of preoperative cardiac CTA imaging as opposed to transthoracic echocardiography (TTE) in the assessment of complications associated to IE, with comparison to surgical findings.

Among 52 patients with surgically proven IE in our database, 24 underwent contrast-enhanced ECG cardiac CTA and were included in the study and all of them also underwent TTE.

For the detection of pseudoaneurysm/abscess in both native and prosthetic valves, cardiac CTA demonstrated significantly higher sensitivity (91.5% vs. 15.8%, p < 0.0001) with similar specificity (81.25). Cardiac CTA demonstrated similar sensitivity and specificity in identifying vegetation and valvular dehiscence in all patients.

Preoperative cardiac CTA can be seen as complementary to TTE in assessing complications such as pseudoaneurysm or abscess of the patients with IE.