Evaluation of causal heart diseases in cardioembolic stroke by cardiac computed tomography

Cardioembolic stroke is a potentially devastating condition and tends to have a poor prognosis compared with other ischemic stroke subtypes.Therefore,it is important for proper therapeutic management to identify a cardiac source of embolism in stroke patients.Cardiac computed tomography(CCT)can detect the detailed visualization of various cardiac pathologies in the cardiac chambers,interatrial and interventricular septum,valves,and myocardium with few motion artifacts and few dead angles.Multiphase reconstruction images of the entire cardiac cycle make it possible to demonstrate cardiac structures in a dynamic manner.Consequently,CCT has the ability to provide high-quality information about causal heart disease in cardioembolic stroke.In addition,CCT can simultaneously evaluate obstructive coronary artery disease,which may be helpful in surgical planning in patients who need urgent surgery,such as cardiac tumors or infective endocarditis.This review will introduce the potential clinical applications of CCT in an ischemic stroke population,with a focus on diagnosing cardioembolic sources using CCT.

Expanding utility of cardiac computed tomography in infective endocarditis: A contemporary review

There is increasing evidence on the utility of cardiac computed tomography(CCT)in infective endocarditis(IE)to investigate the valvular pathology,the extracardiac manifestations of IE and pre-operative planning.CCT can assist in the diagnosis of perivalvular complications,such as pseudoaneurysms and abscesses,and can help identify embolic events to the lungs or systemic vasculature.CCT has also been shown to be beneficial in the pre-operative planning of patients by delineating the coronary artery anatomy and the major cardiovascular structures in relation to the sternum.Finally,hybrid nuclear/computed tomography techniques have been shown to increase the diagnostic accuracy in prosthetic valve endocarditis.This manuscript aims to provide a contemporary update of the existing evidence base for the use of CCT in IE.

Progress in the study and treatment of peri-device leak after left atrial appendage closure

For patients with atrial fibrillation with an increased risk of stroke and contraindications to long-term anticoagulation,percutaneous left atrial appendage closure(LAAC)has become an important alternative to long-term oral anticoagulation.Incomplete closure of the LAAC during the procedure leads to faster blood flow in the interstitial space around the device,resulting in peri-device leak(PDL),which is not uncommon.Studies are still inconclusive in determining the incidence,long-term safety,and management of PDL.Therefore,this article reviewed the progress made in the research and treatment of PDL after LAAC.

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

Infective endocarditis is one of the leading life-threatening infections around the world.With the exponential growth in the field of transcatheter interventions and advances in specialized surgical techniques,the number of prosthetic valves and cardiac implantable devices has significantly increased.This has led to a steep rise in the number of cases of prosthetic valve endocarditis(PVE)comprising up to 30%of all cases.Clinical guidelines rely on the use of the modified Duke criteria;however,the diagnostic sensitivity of the modified Duke criteria is reduced in the context of PVE.This is in part attributed to prosthesis related artifact which greatly affects the ability of echocardiography to detect early infective changes related to PVE in certain cases.There has been increasing recognition of the roles of complementary imaging modalities and updates in international society recommendations.Prompt diagnosis and treatment can prevent the devastating consequences of this condition.Imaging modalities such as cardiac computed tomography and 18-fluorodeoxyglucose positron emission tomography/computed tomography are diagnostic tools that provide a complementary role to echocardiography in aiding diagnosis,pre-operative planning,and treatment decisionmaking process in these challenging cases.Understanding the strengths and limitations of these adjuvant imaging modalities is crucial for the implementation of appropriate imaging modalities in clinical practice.