Visualization of Heart Valve Affection in CRT-ICD Endocarditis Through Full Cardiac Cycle CT-Imaging

Asif MY, Dillinger D, Waldeck S, Zielezinski T and Feyrer R

Department of Cardiac Surgery, Bundeswehr Central Hospital, Germany
Department of Vascular Surgery and Endovascular Surgery, Bundeswehr Central Hospital, Germany
Department of Radiology and Neuroradiology, Bundeswehr Central Hospital, Germany

^*Correspondance to: Mohammed Yusuf Asif 

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Abstract:

A tricuspid valve endocarditis was diagnosed in a 55-year-old female patient six months after CRTICD implantation. She presented with progressive symptoms of general weakness, loss of weight, loss of appetite and severe progressive dyspnea in the hospital which treated her initially. In laboratory test elevated CRP and leukocytosis was seen. The echocardiography showed some suspicious abnormal floating structure on the tricuspid valve. For further evaluation a transesophageal echocardiography was performed, which showed a 3.2 cm × 2 cm vegetation on the Right Ventricular (RV) lead. The patient was referred to our hospital for further diagnostics and treatment. We repeated the transesophageal echocardiography, which brought the same result so we decided to perform a CTscan. A full cardiac cycle CT scan was performed on a photon-counting CT scanner, which showed besides vegetation on RV lead other multiple vegetations on the anterior leaflet of tricuspid valve in 4D imaging. The CT finding convinced us to opt for open surgical explanation of CRT-ICD System and surgical intervention of tricuspid valve. The CRT-ICD System was explanted safely, the vegetations were removed, and the anterior leaflet of tricuspid valve was partly resected and reconstructed using modified De Vega technique.

Keywords:

CRT-ICD System; Tricuspid valve Endocarditis; Photon counting CT scan; Full cardiac cycle CT-imaging

Cite the Article:

Asif MY, Dillinger D, Waldeck S, Zielezinski T, Feyrer R. Visualization of Heart Valve Affection in CRT-ICD Endocarditis Through Full Cardiac Cycle CT-Imaging. Clin Case Rep Int. 2022; 6: 1442.