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

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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.

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Correspondence to Erika Fagman.

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Fagman, E., Perrotta, S., Bech-Hanssen, O. et al. ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis. Eur Radiol 22, 2407–2414 (2012).

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