Fava Agostina M, Xu Bo
Section of Cardiovascular Imaging, Robert and Suzanne Tomsich, Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, United States.
World J Clin Cases. 2021 Oct 26;9(30):8974-8984. doi: 10.12998/wjcc.v9.i30.8974.
Right-sided infective endocarditis is an increasingly recognized disease entity, with tricuspid valve being most frequently involved. Risk factors for tricuspid valve endocarditis (TVIE) include intravenous drug use, cardiac implantable electronic devices and indwelling catheters. Staphylococcus aureus is the predominant causative organism in TVIE. The diagnosis of infective endocarditis (IE) is based on clinical manifestations, blood cultures, and the presence of valvular vegetations detected by echocardiography. Complementary imaging is helpful when there is ongoing clinical suspicion for IE following initially negative echocardiography. Multislice computed tomography allows for assessment of extra-cardiac complications in TVIE, including pulmonary septic emboli. 18F-fluorodeoxyglucose positron emission tomography/computed tomography and radiolabelled white blood cell, single-photon emission computed tomography provide important clinical information concerning the presence of IE in right-sided prosthetic valves or cardiac implantable electronic devices. The aim of this review is to provide an update on TVIE, discussing the role of multimodality imaging in TVIE and the management of these patients.
右侧感染性心内膜炎是一种日益被认识的疾病实体，其中三尖瓣受累最为常见。三尖瓣心内膜炎（TVIE）的危险因素包括静脉药物使用、心脏植入式电子设备和留置导管。金黄色葡萄球菌是TVIE的主要致病微生物。感染性心内膜炎（IE）的诊断基于临床表现、血培养以及超声心动图检测到的瓣膜赘生物。当初次超声心动图检查结果为阴性但临床仍怀疑患有IE时，补充影像学检查会有所帮助。多层计算机断层扫描可用于评估TVIE的心脏外并发症，包括肺脓毒性栓子。18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描以及放射性标记白细胞单光子发射计算机断层扫描可提供有关右侧人工瓣膜或心脏植入式电子设备中IE存在情况的重要临床信息。本综述的目的是提供关于TVIE的最新信息，讨论多模态成像在TVIE中的作用以及这些患者的管理。
