PhD defence A.R. (Ali) Wahadat

Dissertation in short:

Infective Endocarditis (IE) is a destructive and overwhelming cardiovascular disease with high mortality, which can be difficult to diagnose and manage. In 2015, the European Society
of Cardiology (ESC) introduced new guidelines for IE to help facilitate the management of this challenging disease. The guidelines encouraged the consultation of a multidisciplinary
team (The Endocarditis Team) in all cases of (suspected) IE and updated the diagnostic work of patients with suspected IE by including new imaging modalities: the use of 18F-FDG PET/
CT for the detection of metabolic active periprosthetic heart valves as well as extracardiac infectious foci. Furthermore, the use of cardiac CTA is advised for a detailed anatomical
depiction of the heart in all phases of the cardiac cycle. However, literature about the image acquisition, interpretation as well as the applicability of these two imaging techniques was
still relatively limited at the time the guideline was written.

The aim of the present thesis was to investigate the implementation of the 2015 ESC guidelines for IE in The Netherlands (part I), and to investigate the value of a multidisciplinary
approach in the management of IE and to provide possible alternative ways to sustain this approach safely, especially during the COVID-19 pandemic (part II). This thesis also provides
normal PET/CT reference imaging findings and values after prosthetic valve (and ascending aortic prosthesis) implantation and explores the additional diagnostic value of PET/CT and
cardiac CTA in the diagnosis of infective endocarditis in specific patient populations (part III). In addition, it evaluates the current role of cardiac CTA in patients with IE, especially in the
detection of coronary artery disease (part IV).