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Valvulitis: a new echocardiographic criterion for the diagnosis of bioprosthetic aortic valve infective endocarditis.
- Source :
-
Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2024 Oct; Vol. 77 (10), pp. 859-867. Date of Electronic Publication: 2024 Mar 22. - Publication Year :
- 2024
-
Abstract
- Introduction and Objectives: Diffuse homogeneous hypoechoic leaflet thickening, with a wavy leaflet motion documented by transesophageal echocardiography (TEE), has been described in some cases of prosthetic valve endocarditis (PVE) involving aortic bioprosthesis (AoBio-PVE). This echocardiographic finding has been termed valvulitis. We aimed to estimate the prevalence of valvulitis, precisely describe its echocardiographic characteristics, and determine their clinical significance in patients with AoBio-PVE.<br />Methods: From 2011 to 2022, 388 consecutive patients with infective endocarditis (IE) admitted to a tertiary care hospital were prospectively included in a multipurpose database. For this study, all patients with AoBio-PVE (n=86) were selected, and their TEE images were thoroughly evaluated by 3 independent cardiologists to identify all cases of valvulitis.<br />Results: The prevalence of isolated valvulitis was 12.8%, and 20.9% of patients had valvulitis accompanied by other classic echocardiographic findings of IE. A total of 9 out of 11 patients with isolated valvulitis had significant valve stenosis, whereas significant aortic valve regurgitation was documented in only 1 patient. Compared with the other patients with AoBio-PVE, cardiac surgery was less frequently performed in patients with isolated valvulitis (27.3% vs 62.7%, P=.017). In 4 out of 5 patients with valve stenosis who did not undergo surgery but underwent follow-up TEE, valve gradients significantly improved with appropriate antibiotic therapy.<br />Conclusions: Valvulitis can be the only echocardiographic finding in infected AoBio and needs to be identified by imaging specialists for early diagnosis. However, this entity is a diagnostic challenge and additional imaging techniques might be required to confirm the diagnosis. Larger series are needed.<br /> (Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
- Subjects :
- Humans
Male
Female
Aged
Middle Aged
Prospective Studies
Endocarditis diagnosis
Endocarditis epidemiology
Prevalence
Endocarditis, Bacterial diagnosis
Endocarditis, Bacterial epidemiology
Endocarditis, Bacterial complications
Spain epidemiology
Bioprosthesis adverse effects
Echocardiography, Transesophageal methods
Prosthesis-Related Infections diagnosis
Prosthesis-Related Infections epidemiology
Prosthesis-Related Infections etiology
Heart Valve Prosthesis adverse effects
Aortic Valve diagnostic imaging
Aortic Valve surgery
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 1885-5857
- Volume :
- 77
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Revista espanola de cardiologia (English ed.)
- Publication Type :
- Academic Journal
- Accession number :
- 38521440
- Full Text :
- https://doi.org/10.1016/j.rec.2024.03.002