In this small study of 37 patients with suspected endocarditis, researchers examined the diagnostic accuracy of CT (compared to TEE or surgery), in detecting endocarditis. CT (on per valve evaluation) compared favorably to TEE (PPV 93% and NPV 98%) and surgery (PPV 96% and NPV 97%) in detecting valve abnormalities (vegetations, abscesses, perforations, fistulas, or valve dehiscence) (abstract). The authors conclude CT could be usefulfor endocarditis diagnosis after an initial TEE is negative / inconclusive, or for prosthetic valves when metallic artifacts obscure valve visualization on a TEE. Additional pre-op benefits include better anatomic mapping, and ruling in (or out) co-existing CAD (instead of angiography).
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