title: ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis.
abstract: OBJECTIVE
  The aim of this prospective study was to investigate the agreement in findings between ECG-gated CT and transoesophageal echocardiography (TEE) in patients with aortic prosthetic valve endocarditis (PVE).
  
  
  METHODS
  Twenty-seven consecutive patients with PVE underwent 64-slice ECG-gated CT and TEE and the results were compared. Imaging was compared with surgical findings (surgery was performed in 16 patients).
  
  
  RESULTS
  TEE suggested the presence of PVE in all patients [thickened aortic wall (n = 17), vegetation (n = 13), abscess (n = 16), valvular dehiscence (n = 10)]. ECG-gated CT was positive in 25 patients (93 %) [thickened aortic wall (n = 19), vegetation (n = 7), abscess (n = 18), valvular dehiscence (n = 7)]. The strength of agreement [kappa (95 % CI)] between ECG-gated CT and TEE was very good for thickened wall [0.83 (0.62-1.0)], good for abscess [0.68 (0.40-0.97)] and dehiscence [0.75 (0.48-1.0)], and moderate for vegetation [0.55 (0.26-0.88)]. The agreement was good between surgical findings (abscess, vegetation and dehiscence) and imaging for ECG-gated CT [0.66 (0.49-0.87)] and TEE [0.79 (0.62-0.96)] and very good for the combination of ECG-gated CT and TEE [0.88 (0.74-1.0)].
  
  
  CONCLUSIONS
  Our results indicate that ECG-gated CT has comparable diagnostic performance to TEE and may be a valuable complement in the preoperative evaluation of patients with aortic PVE.
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, Bruna stråket 11b, 41345, Gothenburg, Sweden. erika.fagman@vgregion.se
authors.forename: Erika
authors.initials: E
authors.lastname: Fagman
authors.forename: Sossio
authors.initials: S
authors.lastname: Perrotta
authors.forename: Odd
authors.initials: O
authors.lastname: Bech-Hanssen
authors.forename: Agneta
authors.initials: A
authors.lastname: Flinck
authors.forename: Carl
authors.initials: C
authors.lastname: Lamm
authors.forename: Lars
authors.initials: L
authors.lastname: Olaison
authors.forename: Gunnar
authors.initials: G
authors.lastname: Svensson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000473:pathology; D001021:Aortic Valve / Q000503:physiopathology*; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography / Q000379:methods*; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods*