Cherian, Sanjay

Cikirikcioglu, Mustafa

Kalangos, Afksendiyos

Nkoulou, René

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Positron emission tomography–computed tomographyscan helps decision making in cardiac surgerySanjay Cheriana, René Nkouloub, Afksendiyos Kalangosa and Mustafa Cikirikcioglua,*a Division of Cardiovascular Surgery, Medical Faculty, University Hospital of Geneva, Geneva, Switzerlandb Division of Nuclear Medicine, Medical Faculty, University Hospital of Geneva, Geneva, Switzerland* Corresponding author. Division of Cardiovascular Surgery, University Hospital of Geneva, Rue Gabrielle Perret-Gentil 4, Geneva, Switzerland.Tel: +41-22-3727663; fax: +41-22-3727634; e-mail: mustafa.cikirikcioglu@hcuge.ch (M. Cikirikcioglu).Received 29 July 2012; accepted 8 August 2012Keywords: PET-CT • Cardiac interventionA 64-year old male who underwent a mechanical valve Bentall pro-cedure at another institution presented 1 year postoperatively withfever and dyspnoea. Laboratory investigations revealed Candidaalbicans infection with a periprosthetic collection. Confusion as towhether the collection was infective endocarditis, a periprosthetictransudate or a mass of haemostatic plugs used intraoperativelywas clariﬁed by combined positron emission tomography–computed tomography (PET–CT scans; Fig. 1).Figure 1: Contrast CT scans (left panels) of the aortic root in axial (A), two-chamber (B) and three-chamber (C) views showing a collection surrounding the aorticwalls (black arrows). Associated hypermetabolic uptake (white arrows) in 18-F-ﬂouro-deoxyglucose (FDG) scans (right panels) was highly suggestive of an infectiousprocess. The patient made an uneventful postoperative recovery following a replacement of the prosthesis with an aortic homograft. This case presentation rein-forces the role of the PET–CT scan as an important diagnostic tool in cases of difﬁcult decision making in cardiac surgery.© The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.European Journal of Cardio-Thoracic Surgery 43 (2013) 650 IMAGES IN CARDIO-THORACIC SURGERYdoi:10.1093/ejcts/ezs526 Advance Access publication 30 October 2012

Positron emission tomography-computed tomography scan helps decision making in cardiac surgery

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