Acute myocardial ischemia after aortic valve replacement: a comprehensive diagnostic evaluation using dynamic multislice spiral computed tomography.
We describe the case of a 72-year-old man presenting with endocarditis and clinical signs of acute myocardial ischemia after biological aortic valve replacement. A comprehensive cardiac dynamic multislice spiral computed tomography demonstrated: (1) an endocarditic vegetation of the aortic valve; (2) a subvalvular leakage feeding a paravalvular pseudoaneurysm based on an aortic root abscess with subsequent compromise of the systolic blood flow in the left main coronary artery and the resulting myocardial perfusion deficit.
Lembcke
Alexander
A
Department of Radiology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany. alexander.lembcke@gmx.de
Hein
Patrick A
PA
Enzweiler
Christian N H
CN
Hoffmann
Udo
U
Klessen
Christian
C
Dohmen
Pascal M
PM
D000368:Aged; D000465:Algorithms; D001021:Aortic Valve / Q000000981:diagnostic imaging*; D001705:Bioprosthesis / Q000382:microbiology*; D004696:Endocarditis / Q000150:complications / Q000000981:diagnostic imaging*; D006350:Heart Valve Prosthesis / Q000382:microbiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*