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(Circulation. 2000;101:e188.)
© 2000 American Heart Association, Inc.

Circulation Electronic Pages

Stentocarditis

Benno J. Rensing, MD; Robert Jan van Geuns, MD; Maarten Janssen, MD; Matthijs Oudkerk, MD; Pim J. de Feyter, MD

From the Department of Cardiology (B.J.R., R.J.v.G., M.J., P.J.d.F.), Thoraxcenter, and Department of Radiology (M.O.), Dr Daniel den Hoed Kliniek, Rotterdam, Netherlands.

Correspondence to Benno J. Rensing, MD, Thoraxcenter, BD 416, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands. E-mail rensing@card.azr.nl

	Introduction

 
The patient was a 67-year-old man who had received 3 single venous aortocoronary bypass grafts in 1978. He remained free of symptoms until mid-1998, when he was admitted with unstable angina. Angiography revealed severe stenoses in the vein grafts to both the right coronary artery (RCA) and the obtuse marginal (OM) branch of the circumflex artery. Three stents were successfully implanted in the OM graft, and 1 stent was implanted in the graft to the RCA. The postprocedural course was uneventful, and the patient was discharged the next day. Four days later, however, he was readmitted with high fever, chills, and malaise. Blood cultures were repeatedly positive for Staphylococcus aureus, and treatment with intravenous antibiotics was begun. During admission, he developed chest pain, with minimal ST-segment depression in the inferolateral ECG leads. Creatine phosphokinase levels rose to 1500 IU/L (normal <240 IU/L). An extensive search for the source of the infection was negative. We decided to perform an electron-beam tomographic (EBT, or ultrafast CT) examination of the thorax to look for a pulmonary, mediastinal, or cardiac source for the infection and to check bypass graft patency.

Forty ECG-triggered, contrast-enhanced, consecutive tomograms were made at inspiration, starting just above the aortic arch. Tomogram thickness was set at 3 mm, with a 2-mm table increment after each scan. Acquisition time was 100 ms. Contrast (150 mL) was injected at 4 mL/s through an arm vein. 3D volume renderings were made with Voxel View software on a Silicon Graphics workstation.

The graft . . . [Full Text of this Article]

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