Multimodality imaging in the diagnosis and management of prosthetic valve endocarditis: A contemporary narrative review

Figure 6 Transesophageal echocardiogram and cardiac computed tomography in a patient with metallic aortic valve replacement endocarditis, complicated by aortic dissection. Sixty-two year-old male with a history of type A aortic dissection status post repair with #27 CarboMedics valve conduit with reimplantation of the coronary arteries, #28 mm Hemashield bridge graft to the distal ascending aorta, presenting with PVE and extension of dissection from the distal ascending aorta to the femoral arteries. His transesophageal echocardiogram demonstrated the presence of a metallic AVR with pathological thickening of the aorto-mitral curtain and aortic root posteriorly (A and B: Star). Cardiac computed tomography axial view of the metallic aortic valve demonstrated widely open occluders and further inspection of the aorta at the level of the arch demonstrated the aortic dissection extending into the descending thoracic aorta (C and D: Arrow). RA: Right atrium; RV: Right ventricle; LA: Left atrium.