The PET/ Control study: repeat PET-CT scans in the follow up of non-operated patients with prosthetic valve endocarditis.

Purpose : Our aim is to describe our real-life experience in the follow- up of patients with prosthetic valve endocarditis (PVE) who were treated conservatively and compare the features of those who had 18-fluorine-fluorodeoxyglucose positron emission tomography coupled with computed tomography (PET-CT) follow-up to those without PET-CT follow-up. Methods : We performed a post hoc analysis of cardiac PET CT scan results of adult patients with definite PVE, prospectively included at a cardiology referral center. Patients treated conservatively with PET-CT follow-up (group 1) were compared to those without PET-CT follow-up (group 2). Statistics were performed with Jamovi 2.6.13. Results : Patients who had PET CTRL had higher Euroscore II (19 vs 13.2, p=0.008), more pacemakers (21.2% vs 0, p < 0.001), more spondylodiscitis (21.2% vs 10.9% p NS) and more enterococci (26.9% vs 14.5%, p NS). Surgery was indicated for 50.0% of group 1, vs 36.4% of group 2(p NS). Prolonged antibiotic treatment was given for 42/52(80.8%) of the PET CTRL group vs 5/55(9%) (p< 0.00001, OR 0.024, 95%CI 0.008- 0.075). Follow up PET CT was helpful in stopping or continuing antimicrobials for 25/42 (59.5%). There were no hospitalizations due to IE relapses in either group over the period of 1 year. Death at 1 year was seen in 6.3% vs 16.3% (p NS). Conclusion : Sequential PET-CT was mainly used to guide the duration of antimicrobial therapy, especially in patients with PVE with more complex or severe profiles. PET-CT may complement clinical and biological assessment in selected inoperable patients with PVE.