Prosthetic Valve Endocarditis Risks
Prosthetic Valve Endocarditis Risks Prosthetic valve endocarditis is a condition where the prosthetic heart valve becomes infected, leading to inflammation and tissue damage. It is different from other forms of endocarditis as it specifically affects individuals who have undergone valve replacement surgery.
Furthermore, we will explore recent research developments and advancements in the field, as well as offer practical tips and strategies for managing daily challenges associated with prosthetic valve endocarditis.
Join us as we navigate through the intricacies of this condition and the steps you can take to safeguard your health. It is essential to stay informed, vigilant, and proactive in addressing prosthetic valve endocarditis to ensure the best possible outcomes for yourself or your loved ones.
What is Prosthetic Valve Endocarditis?
Prosthetic valve endocarditis is a serious infection that specifically targets artificial heart valves. It is a form of infective endocarditis that occurs when bacteria or other microorganisms invade the prosthetic valve and cause an infection. This condition is characterized by inflammation and damage to the heart valve, which can lead to severe complications if left untreated.
Unlike other forms of endocarditis, which can affect both natural and prosthetic heart valves, prosthetic valve endocarditis specifically affects individuals who have undergone valve replacement surgery. Although the risk of developing this infection is relatively low, it is a significant concern for those with prosthetic heart valves.
There are several factors that can contribute to the development of prosthetic valve endocarditis. These include recent dental procedures, surgeries, or invasive medical interventions that can introduce bacteria into the bloodstream. Additionally, individuals with pre-existing heart conditions, a history of endocarditis, or a compromised immune system may have a higher risk of developing prosthetic valve endocarditis.
If prosthetic valve endocarditis is suspected, prompt medical attention is crucial. Early diagnosis and treatment are essential in preventing further damage to the heart valve and reducing the risk of life-threatening complications. In the next section, we will explore the common symptoms and signs of prosthetic valve endocarditis, helping individuals recognize potential changes in their health that may indicate the presence of this infection.
Symptoms of Prosthetic Valve Endocarditis
Prosthetic valve endocarditis is a serious infection that can occur in individuals who have a prosthetic heart valve. Recognizing the symptoms and signs of this condition is crucial for early detection and prompt treatment. Here are some common indications to look out for:
- Unexplained fever: One of the primary symptoms of prosthetic valve endocarditis is an unexplained fever. If you have a prosthetic heart valve and experience a persistent fever without any apparent cause, it may be a sign of an infection.
- Chills and sweats: Along with fever, you may also experience chills and excessive sweating. These symptoms can occur as your body tries to fight off the infection.
- General fatigue and weakness: Prosthetic valve endocarditis can cause general fatigue and weakness, making it difficult to carry out daily activities. If you notice a significant decline in your energy levels, it’s important to discuss it with your healthcare provider.
- Shortness of breath: In some cases, prosthetic valve endocarditis can lead to shortness of breath or difficulty breathing. This symptom may indicate a severe infection that requires immediate medical attention.
- Chest pain: Chest pain or discomfort can be a symptom of prosthetic valve endocarditis. It can range from mild to severe and may be felt as a sharp or dull sensation.
- Changes in heart rhythm: Prosthetic valve endocarditis can disrupt the normal electrical signals of the heart, leading to changes in heart rhythm. You may experience irregular heartbeats, palpitations, or a sensation of your heart racing.
- Unexplained weight loss: A significant and unexplained weight loss may be a symptom of prosthetic valve endocarditis. If you notice a sudden drop in weight without changes in diet or exercise, it’s important to talk to your doctor.
If you have a prosthetic heart valve and experience any of these symptoms, it’s essential to seek medical attention promptly. Prosthetic valve endocarditis is a serious condition that requires immediate treatment to prevent potential complications. Your healthcare provider will be able to evaluate your symptoms, perform necessary tests, and provide the appropriate care.
Diagnosing Prosthetic Valve Endocarditis
Diagnosing prosthetic valve endocarditis involves a comprehensive evaluation that incorporates various medical assessments. The diagnostic process aims to identify signs and symptoms indicative of prosthetic valve endocarditis and rule out other potential causes.
During the diagnostic journey, healthcare professionals may follow these essential steps:
- Medical History: The doctor will gather detailed information about the patient’s medical history, including any previous cardiac procedures, such as prosthetic valve placement, or a history of endocarditis infections. This allows them to assess the individual’s risk factors and determine the need for further investigations.
- Physical Examination: A thorough physical examination will be conducted to inspect for any signs of endocarditis symptoms. The doctor may listen to the heart sounds, check for the presence of a heart murmur, and examine other areas of the body for potential signs of infection.
- Laboratory Tests: Laboratory tests play a crucial role in the diagnosis of prosthetic valve endocarditis. Blood cultures will be collected to identify the presence of bacteria or other infectious agents in the bloodstream. Additional blood tests, such as complete blood count (CBC) and inflammatory markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), can provide further insights into the patient’s condition.
- Imaging Studies: Imaging techniques can help visualize abnormalities and signs of infection in the heart and surrounding structures. Transesophageal echocardiography (TEE) is particularly useful in diagnosing prosthetic valve endocarditis as it offers a detailed examination of the heart valves and can detect vegetation or abscess formation. Other imaging modalities, such as chest X-rays and computed tomography (CT) scans, may also be used to evaluate the extent of infection and its impact on nearby organs.
Combining the information obtained from the medical history, physical examination, laboratory tests, and imaging studies allows healthcare professionals to make an accurate diagnosis of prosthetic valve endocarditis. A prompt and accurate diagnosis is crucial for initiating appropriate treatment and preventing potential complications.
| Diagnostic Steps for Prosthetic Valve Endocarditis | Advantages | Considerations |
|---|---|---|
| Medical History | – Identifies risk factors – Provides context for symptoms |
– Patient recall may be incomplete – Relies on patient’s ability to provide accurate information |
| Physical Examination | – Identifies physical signs of endocarditis – Assists in determining severity |
– Some signs may be nonspecific – Relies on examiner’s experience and expertise |
| Laboratory Tests | – Detects presence of infectious agents – Assesses inflammatory markers |
– False negatives possible early in infection – Results may require interpretation within clinical context |
| Imaging Studies | – Visualizes heart structures and abnormalities – Detects vegetation, abscesses, or other complications |
– Transesophageal echocardiography (TEE) may have limitations in certain individuals – Radiation exposure in some imaging modalities |
Treatment Options for Prosthetic Valve Endocarditis
Effective treatment is crucial for managing prosthetic valve endocarditis and preventing further complications. The approach to treatment may vary depending on the severity of the infection and individual patient factors. In most cases, a combination of antibiotic therapy and surgical interventions is required to address the infection and restore heart function.
Antibiotic Therapy
Antibiotics play a central role in the treatment of prosthetic valve endocarditis. The specific choice of antibiotics will depend on factors such as the causative microorganism, the patient’s medical history, and any identified antibiotic resistance patterns. Intravenous (IV) antibiotics are typically administered for a prolonged period, often spanning several weeks. This extended duration is necessary to fully eradicate the infection and prevent relapse.
During antibiotic treatment, regular monitoring of the patient’s response is essential. Blood tests may be conducted to assess the effectiveness of the chosen antibiotics and ensure they are appropriately targeting the infection.
It’s important for patients to strictly adhere to the prescribed antibiotic regimen and complete the full course of treatment, even if symptoms improve. Premature discontinuation of antibiotics can lead to treatment failure or the development of antibiotic-resistant strains of bacteria.
Surgical Interventions
In certain cases, surgical intervention may be necessary to treat prosthetic valve endocarditis. Surgical options may include:
- Valve debridement: This procedure involves the removal of infected tissue and debris from the prosthetic valve, followed by repair and reconstruction.
- Valve replacement: If the prosthetic valve is severely damaged or unable to be effectively treated, it may need to be replaced. This is typically done with either a mechanical valve or a tissue valve.
- Additional repairs: In some instances, other cardiac structures may be affected by the infection, such as the surrounding tissue or the native heart valves. Additional surgical repairs may be needed to address these complications.
The decision to perform surgical intervention is often made based on factors such as the patient’s overall health, the severity of the infection, and the extent of damage to the prosthetic valve. Surgical treatment aims to remove the source of infection, restore proper valve function, and reduce the risk of further complications.
Complication Management
Prosthetic valve endocarditis can lead to various complications, such as heart failure, embolic events, and abscess formation. The management of these complications may require additional interventions, such as:
- Medications to manage heart failure symptoms and improve cardiac function.
- Anticoagulant therapy to prevent blood clots and reduce the risk of embolic events.
- Drainage or surgical intervention to address abscesses and prevent their spread.
Comprehensive management by a multidisciplinary healthcare team is vital to optimize treatment outcomes and minimize the long-term effects of prosthetic valve endocarditis.
| Treatment Options | Key Points |
|---|---|
| Antibiotic Therapy | – Selection of antibiotics based on microorganism and patient factors – Prolonged IV antibiotic administration – Regular monitoring of response |
| Surgical Interventions | – Valve debridement to remove infected tissue – Valve replacement if necessary – Additional repairs for complications |
| Complication Management | – Medications for heart failure and embolic event prevention – Drainage or surgical intervention for abscesses |
Preventing Prosthetic Valve Endocarditis
Prevention plays a crucial role in reducing the risk of prosthetic valve endocarditis. By following recommended guidelines and adopting healthy practices, individuals with prosthetic heart valves can minimize the likelihood of developing this serious infection. Here are some key strategies for preventing prosthetic valve endocarditis:
Maintain Good Oral Hygiene
Endocarditis prevention starts with taking care of your oral health. Regular brushing and flossing help remove bacteria from your mouth, reducing the risk of them entering your bloodstream. Additionally, using an antiseptic mouthwash can further inhibit the growth of harmful bacteria.
Visit Your Dentist Regularly
Routine dental visits are essential for prosthetic valve endocarditis prevention. Your dentist can monitor your oral health, identify any signs of infection or inflammation, and provide appropriate treatment. Regular cleanings and examinations help maintain the health of your teeth and gums, reducing the risk of bacterial colonization and subsequent infection.
Follow Antibiotic Prophylaxis Recommendations
Antibiotic prophylaxis is recommended for individuals with prosthetic heart valves when undergoing certain dental procedures. This preventive measure involves taking antibiotics before the dental treatment to lower the risk of bacteria entering the bloodstream and causing an infection. It is crucial to consult with your cardiologist and dentist to determine the appropriate antibiotic prophylaxis regimen based on your specific situation.
Take Precautions with Other Invasive Procedures
In addition to dental procedures, other invasive medical or surgical interventions can also pose a risk for prosthetic valve endocarditis. It is important to inform your healthcare providers about your prosthetic valve and discuss the need for antibiotic prophylaxis or other preventive measures.
Adhere to Guidelines and Recommendations
Following prosthetic valve endocarditis guidelines set forth by medical professionals is crucial in preventing this infection. These guidelines are based on extensive research and aim to provide the best practices for managing and preventing prosthetic valve endocarditis. It is important to stay informed and work closely with your healthcare team to ensure you are taking the necessary steps to protect your heart health.
By implementing these preventive strategies, individuals with prosthetic heart valves can significantly reduce the risk of prosthetic valve endocarditis. It is vital to prioritize oral hygiene, seek regular dental care, and adhere to recommended guidelines to safeguard your heart health.
Risks and Complications of Prosthetic Valve Endocarditis
Prosthetic valve endocarditis, a serious infection of artificial heart valves, can lead to various risks and complications that can significantly impact a patient’s health and well-being. Understanding these potential complications is crucial for both patients and healthcare providers in managing and treating this condition effectively.
Impact on Heart Function
One of the primary risks of prosthetic valve endocarditis is its detrimental effect on heart function. The infection can cause inflammation and damage to the heart valve, impairing its ability to regulate blood flow properly. As a result, patients may experience symptoms such as fatigue, shortness of breath, and chest discomfort. In severe cases, this compromised heart function can lead to heart failure.
Risk of Valve Failure
Prosthetic valve endocarditis increases the risk of valve failure, which may require surgical intervention for valve replacement. The infection can weaken the valve structure, leading to leakage or improper closure and disrupting the normal flow of blood through the heart. Valve failure can significantly compromise cardiovascular health and necessitate additional surgeries and lifelong management.
Increased Likelihood of Embolic Events
Another complication associated with prosthetic valve endocarditis is the increased risk of embolic events. The infection can cause the formation of blood clots on the damaged valve, which can break loose and travel to other parts of the body, obstructing blood vessels. These embolic events can result in severe consequences, including strokes, organ damage, or limb ischemia.
| Risk and Complication | Description |
|---|---|
| Impact on Heart Function | Prosthetic valve endocarditis can impair the heart’s ability to regulate blood flow properly, potentially leading to heart failure. |
| Risk of Valve Failure | The infection can weaken the structure of the artificial valve, increasing the likelihood of valve failure and the need for replacement surgery. |
| Increased Likelihood of Embolic Events | Prosthetic valve endocarditis raises the risk of blood clots forming on the damaged valve and causing blockages in blood vessels, leading to potentially severe consequences such as strokes or organ damage. |
These risks and complications underline the importance of early detection, timely treatment, and ongoing monitoring for individuals with prosthetic valve endocarditis. By understanding and addressing these potential complications, healthcare providers and patients can work together to minimize the impact of this serious condition on overall health and quality of life.
Prognosis and Long-Term Outlook for Prosthetic Valve Endocarditis
Understanding the prognosis and long-term outlook for individuals with prosthetic valve endocarditis is crucial for their overall well-being. While the condition presents serious health risks, timely treatment and ongoing monitoring can significantly improve outcomes.
Potential Outcomes
The prognosis for prosthetic valve endocarditis varies depending on several factors, including the type of infecting microorganism, the extent of valve damage, and the individual’s overall health. Without prompt and appropriate treatment, prosthetic valve endocarditis can lead to life-threatening complications, such as heart failure, valve dysfunction, and embolic events.
- Heart failure: Prosthetic valve endocarditis can weaken the heart muscle and impair its ability to effectively pump blood.
- Valve dysfunction: Infection can cause damage to the prosthetic valve, leading to regurgitation (leaking of blood) or stenosis (narrowing of the valve).
- Embolic events: Fragments of infected material can break off and travel through the bloodstream, potentially causing blockages in vital organs or blood vessels.
Ongoing Monitoring and Follow-Up Care
Following treatment for prosthetic valve endocarditis, individuals require lifelong monitoring and follow-up care to ensure optimal recovery and prevent recurrence of the infection. Regular check-ups with healthcare providers, including cardiologists and infectious disease specialists, are essential to monitor valve function, manage any complications, and assess the effectiveness of treatment.
Ongoing monitoring may involve:
- Regular echocardiograms to evaluate prosthetic valve function and detect any abnormalities.
- Periodic blood tests to check for signs of infection and monitor inflammatory markers.
- Evaluation of symptoms to detect any recurrence or worsening of the condition.
Additionally, individuals with prosthetic valve endocarditis may need to take long-term antibiotic prophylaxis prior to certain invasive medical procedures to prevent the risk of reinfection.
| Prognosis Factors | Positive Outlook | Challenges |
|---|---|---|
| Early diagnosis and prompt treatment | Improved chances of successful recovery | If left untreated, potential complications can arise |
| Absence of complications or severe damage to the prosthetic valve | Lower risk of long-term health implications | Complications can occur, requiring additional interventions |
| Adherence to follow-up care and ongoing monitoring | Early detection of recurrence or complications | Non-compliance may lead to undetected or worsening infection |
By remaining vigilant in their care and seeking appropriate medical attention, individuals with prosthetic valve endocarditis can improve their overall outlook and maintain a better quality of life.
Support and Resources for Prosthetic Valve Endocarditis Patients
Living with prosthetic valve endocarditis can be challenging, but you don’t have to face it alone. There are numerous support and resources available to help you navigate this journey and find the assistance you need. Here are some valuable options:
Patient Organizations
Connect with patient organizations dedicated to prosthetic valve endocarditis. These organizations provide information, advocacy, and a community of individuals who understand what you’re going through. They offer support groups, educational materials, and resources to help you manage your condition.
- \Prosthetic Heart Valve Support Group: A community-driven organization that connects patients, caregivers, and medical professionals to share experiences, offer support, and provide valuable resources.*\
- \Endocarditis Hope: A nonprofit organization dedicated to raising awareness about prosthetic valve endocarditis and providing support through online forums, information resources, and patient advocates.*\
Online Communities
Join online communities focused on prosthetic valve endocarditis. These forums and social media groups provide a platform to interact with fellow patients, ask questions, share experiences, and receive support from a supportive community.
- \Heart Connect: An online community where individuals with heart conditions, including prosthetic valve endocarditis, come together to share stories, provide encouragement, and find valuable resources.*\
- \Endocarditis Support Group on Facebook: A Facebook group that serves as a safe space for individuals affected by prosthetic valve endocarditis to connect, share information, and seek support from others who understand their journey.*\
Medical Professionals
Consult with your healthcare team for guidance and support. Your doctors, nurses, and other healthcare providers will be able to provide valuable information about managing prosthetic valve endocarditis and connecting you with specialized resources.
Additional Resources
Explore additional resources that can provide helpful information and support:
- \American Heart Association: Visit their website for educational materials, guidelines, and resources related to heart health and prosthetic valve endocarditis.*\
- \Heart Valve Voice: A patient-led organization that aims to raise awareness, provide resources, and facilitate discussions about heart valve disease, including prosthetic valve endocarditis.*\
Remember, reaching out for support is a sign of strength. Don’t hesitate to lean on others who can help you navigate the challenges of prosthetic valve endocarditis. Together, we can find strength and support in our journey.
Prosthetic Valve Endocarditis Research and Advances
In recent years, there have been significant advancements in the research and treatment of prosthetic valve endocarditis. Researchers and medical professionals are continuously working to improve diagnostic methods, develop more effective therapies, and enhance the overall management of this complex condition.
1. Diagnostic Innovations
New diagnostic tools and techniques are being explored to help identify prosthetic valve endocarditis at an earlier stage. One promising development is the use of molecular imaging, such as positron emission tomography (PET) scans, which can provide detailed insights into the extent and location of infection.
Additionally, researchers are investigating the use of biomarkers, such as C-reactive protein (CRP) and procalcitonin, which may help distinguish between infective and non-infective causes of symptoms in patients with prosthetic valve endocarditis.
2. Antibiotic Therapy
Advancements in antibiotic therapy are another area of focus. Researchers are studying the efficacy of different antibiotic regimens to optimize treatment outcomes for prosthetic valve endocarditis.
Furthermore, efforts are being made to develop targeted antimicrobial therapies that can eradicate the infective agents more effectively, reducing the risk of complications and improving long-term outcomes.
3. Surgical Approaches
Surgical interventions play a crucial role in the management of prosthetic valve endocarditis. Ongoing research aims to refine surgical techniques and improve patient outcomes.
For example, minimally invasive surgical approaches, such as robotic-assisted surgery, are being explored as alternative options to traditional open-heart surgery. These less invasive procedures may offer shorter recovery times, reduced complications, and improved quality of life for patients.
4. Prophylaxis Guidelines
Another important aspect of research and advancements in prosthetic valve endocarditis is the development of updated prophylaxis guidelines. These guidelines help healthcare professionals make informed decisions regarding antibiotic prophylaxis before dental or surgical procedures.
Efforts are being made to refine and update these guidelines based on the latest evidence and research findings, ensuring that patients with prosthetic heart valves receive appropriate prophylactic measures to reduce the risk of infection.
5. Future Directions
The field of prosthetic valve endocarditis research continues to evolve, with ongoing studies investigating new treatment modalities and exploring innovative approaches to manage this challenging condition.
Some areas of future research interest include the development of novel antimicrobial agents, the use of immunotherapy to enhance the body’s immune response against infective agents, and the potential of regenerative medicine to repair and replace damaged prosthetic heart valves.
| Advancements | Impact |
|---|---|
| Molecular imaging | Improved localization and staging of infection |
| Biomarkers | Enhanced diagnostic accuracy and differentiation |
| Refined antibiotic therapy | Better treatment outcomes and reduced complications |
| Minimally invasive surgery | Shorter recovery times and improved quality of life |
| Updated prophylaxis guidelines | Reduced risk of infection for patients |
Living with Prosthetic Valve Endocarditis: Tips and Strategies
Living with prosthetic valve endocarditis can pose unique challenges, but with the right tips and strategies, individuals can effectively manage their condition and maintain a good quality of life. Here are some practical recommendations to consider:
1. Follow a Healthy Lifestyle
Adopting a healthy lifestyle is crucial for managing prosthetic valve endocarditis. This includes eating a nutritious diet, exercising regularly, getting enough sleep, and avoiding smoking and excessive alcohol consumption. These lifestyle modifications can contribute to overall well-being and minimize the risk of complications.
2. Practice Good Oral Hygiene
Proper oral hygiene is essential for preventing infections, including prosthetic valve endocarditis. Brush your teeth twice a day, floss daily, and visit your dentist regularly for cleanings and check-ups. It may also be beneficial to use an antimicrobial mouthwash recommended by your healthcare provider.
3. Take Medications as Prescribed
If you’ve been prescribed antibiotics or other medications to manage your prosthetic valve endocarditis, it’s crucial to take them as directed by your healthcare team. Adhering to the prescribed treatment plan can help control the infection and reduce the risk of complications.
4. Keep Up with Medical Appointments
Regular follow-up appointments with your cardiologist and healthcare team are essential for monitoring your condition and adjusting your treatment plan, if necessary. Ensure that you attend all scheduled appointments and communicate any new symptoms or concerns to your healthcare provider.
5. Manage Emotional Well-being
Coping with a chronic condition like prosthetic valve endocarditis can be challenging emotionally. It’s important to prioritize your mental health and seek support from loved ones, support groups, or mental health professionals if needed. Engaging in activities that bring you joy and practicing relaxation techniques can also help alleviate stress.
6. Educate Yourself and Others
Knowledge is empowering when dealing with prosthetic valve endocarditis. Take the time to educate yourself about your condition, its management, and potential complications. Additionally, consider educating your family and close friends about prosthetic valve endocarditis, so they can better understand your needs and provide support.
7. Reach Out to Support Groups
Connecting with others who are also living with prosthetic valve endocarditis can provide a sense of belonging and understanding. Consider joining online support groups or seeking out local support groups where you can share experiences, gain insights, and receive valuable emotional support.
8. Communicate Openly with Your Healthcare Team
Honest and open communication with your healthcare team is essential for managing prosthetic valve endocarditis effectively. Share any concerns or questions you may have about your condition, treatment plan, or lifestyle adjustments. Your healthcare team is there to support you and help you navigate your journey.
9. Stay Positive and Stay Informed
Maintaining a positive mindset and staying informed about advancements in prosthetic valve endocarditis research and treatments can provide hope and inspiration. Keep yourself updated with credible sources of information to gain insights into new developments that may benefit you in the future.
| Tips for Living with Prosthetic Valve Endocarditis |
|---|
| Follow a healthy lifestyle |
| Practice good oral hygiene |
| Take medications as prescribed |
| Keep up with medical appointments |
| Manage emotional well-being |
| Educate yourself and others |
| Reach out to support groups |
| Communicate openly with your healthcare team |
| Stay positive and stay informed |
Conclusion
Prosthetic valve endocarditis is a serious infection that can lead to severe complications if left untreated. Throughout this article, we have explored the risks, symptoms, diagnosis, treatment options, and prevention strategies for this condition. It is crucial to emphasize the importance of early detection and prompt treatment to minimize the impact of prosthetic valve endocarditis on an individual’s health.
By understanding the signs and symptoms of prosthetic valve endocarditis, individuals with a prosthetic heart valve can take proactive measures to seek medical attention promptly. This includes regular follow-up appointments, practicing good oral hygiene, and adhering to antibiotic prophylaxis guidelines during certain dental procedures.
Ultimately, the key to managing prosthetic valve endocarditis lies in a collaborative effort between healthcare professionals and individuals with the condition. Continuous monitoring, adherence to medication regimens, and open communication with the healthcare team can improve the long-term outlook for those living with prosthetic valve endocarditis.
FAQ
What is prosthetic valve endocarditis?
Prosthetic valve endocarditis is a serious infection that affects individuals who have undergone valve replacement surgery. It occurs when bacteria or fungi enter the bloodstream and attach to the prosthetic heart valve, leading to inflammation and damage.
What are the symptoms of prosthetic valve endocarditis?
Symptoms of prosthetic valve endocarditis can vary, but common signs include fever, fatigue, chills, night sweats, shortness of breath, chest pain, and joint or muscle aches. It is important to seek medical attention if any of these symptoms develop or worsen.
How is prosthetic valve endocarditis diagnosed?
The diagnosis of prosthetic valve endocarditis involves a thorough evaluation by a healthcare professional. This typically includes a review of the patient's medical history, physical examination, blood tests (such as blood cultures), and imaging studies (such as echocardiography) to confirm the presence of an infection on the prosthetic heart valve.
