Vall d'Hebron improves the diagnosis of endocarditis in prosthetic valves and medical devices

The Endocarditis Unit and the Nuclear Cardiology Unit of the Vall d’Hebron University Hospital have published their clinical research about the diagnosis of endocarditis in prosthetic valves and medical devices using Positron Emission Tomography/Computed Tomography, also known as PET/CT, in the prestigious journal Circulation. It has been established that PET-CT can diagnose non-identified cases of prosthetic endocarditis when it is included in the diagnostic criteria approved up to today. Researchers from the Cardiocirculatory Pathology group, the Reparative Therapy of the Heart group and the Infectious Diseases group of Vall d’Hebron Institute of Research (VHIR) and the Institut de Diagnòstic per la Imatge (IDI) of VHIR and the Universitat Autònoma de Barcelona (UAB) have also been part of the research.

For this study, 92 patients with prosthetic heart valves or intracardiac devices with suspected endocarditis were studied at the hospital between November 2012 and November 2014. An echocardiography and PET/CT technique was performed in all patients and also the most of them received a computed tomographic angiography (CTA). As a result, PET/CT technique not only made easier to correctly classify cases that were suspicious, but also, when combined with CTA, enabled detection of a larger number of anatomic lesions associated to endocarditis.

Thanks to these results and those obtained by other institutions, PET-CT techniques have recently been included as major criteria in the Guidelines of clinical practice for the management of infective endocarditis by the European Society of Cardiology for this type of patients.

Infective endocarditis, specially endocarditis associated to prosthetic heart valves and medical devices, is a very rare pathology and difficult to diagnose but its very poor prognosis has been little modified despite of the medical progress in treatment.

On the other hand, the Nuclear Cardiology unit, with more than 30 years of experience, is also the result of the cooperation among between the services of Nuclear Medicine and Cardiology and it is also made up of an interdisciplinary team of nuclear clinicians, cardiologists and radiologists.

Since 2012, when the IDI/ Vall d’Hebron Unit installed the PET-CT technique, both units have been working for the development of this new technique (a global innovating technique) as a diagnostic method for prosthetic endocarditis. Given the fact that there are still too many aspects to consider regarding PET/CT and infective endocarditis, the researchers hope to continue delving into these studies in the near future.