HomeClinicalSecondary valvular insufficiency after valvular repair

Secondary valvular insufficiency after valvular repair

    Author: Christian Loewe, Vienna, Austria
    Body Region: Cardiovascular

    1. Patient Presentation
    2. CT Images
    3. CT Findings
    4. Diagnosis
    5. References

    1. Patient Presentation

    • A now 34-year-old male patient with a history of several years of intravenous drug abuse was first admitted to hospital 2 years ago because of dyspnea during exercise and chronic fatigue.
    • His C-reactive protein level and white-blood cell count were elevated.
    • Due to the suspicion of aortic valve endocarditis at echocardiography, CT angiography of the entire aorta was performed to assess the aortic valve and investigate possible systemic complications (Figure 1).
    • CT angiography confirmed the aortic valve endocarditis and the patient was treated with a mechanical aortic valve implanted by open surgery.
    • Owing to recurrence of the endocarditis, a secondary valvular repair with a bioprosthesis was performed one year later (images not shown).
    • The patient has been recently re-admitted to the Chest Pain Unit because of rapidly progressing dyspnea during exercise.
    • Echocardiography confirmed an aortic vitium combining relevant regurgitation and stenosis.
    • Additionally, CT angiography was performed to visualize/rule out paravalvular changes and systemic complications (Figure 2).