European Radiology

, Volume 22, Issue 11, pp 2407–2414 | Cite as

ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis

  • Erika FagmanEmail author
  • Sossio Perrotta
  • Odd Bech-Hanssen
  • Agneta Flinck
  • Carl Lamm
  • Lars Olaison
  • Gunnar Svensson



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).


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).


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)].


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.


Heart valve prosthesis Prosthetic valve endocarditis Aortic valve ECG-gated computed tomography Transoesophageal echocardiography 



contrast medium




prosthetic valve endocarditis


transoesophageal echocardiography

Supplementary material


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(MPG 272 kb)


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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Erika Fagman
    • 1
    Email author
  • Sossio Perrotta
    • 2
  • Odd Bech-Hanssen
    • 3
    • 4
  • Agneta Flinck
    • 1
  • Carl Lamm
    • 1
  • Lars Olaison
    • 5
  • Gunnar Svensson
    • 2
    • 6
  1. 1.Department of RadiologySahlgrenska University HospitalGothenburgSweden
  2. 2.Department of Cardiovascular Surgery and AnaesthesiaSahlgrenska University HospitalGothenburgSweden
  3. 3.Department of Clinical PhysiologySahlgrenska University HospitalGothenburgSweden
  4. 4.Department of CardiologySahlgrenska University HospitalGothenburgSweden
  5. 5.Department of Infectious DiseasesSahlgrenska University HospitalGothenburgSweden
  6. 6.Department of Molecular and Clinical Medicine, Institute of MedicineThe Sahlgrenska Academy at the University of GothenburgGothenburgSweden

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