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This study examines whether adding cardiac computed tomography (CCT) improves detection of such complications. 32 endocarditis cases who underwent TEE, CCT, and cardiac surgery were retrospectively analysed. Three expert cardiologists independently reviewed anonymised TEEs followed by corresponding CCTs. Diagnostic performance for detecting aortic root abscesses and pseudoaneurysms was assessed against surgical findings as gold standard. ROC curves and AUC compared the two modalities. 13\/32 cases had abscess\/pseudoaneurysms (8 abscesses, 8 pseudoaneurysms). Accuracy increased from 88% with TEE to 91% with TEE\u2009+\u2009CCT. Sensitivity improved from 85% to 100% while specificity decreased from 89% to 84%. CCT increased NPV to 100% and diagnostic confidence in 91% of cases. AUC tended higher for TEE\u2009+\u2009CCT than TEE alone (0.92 vs. 0.87, p\u2009=\u20090.47). For pseudoaneurysms, CCT increased AUC (TEE\u2009+\u2009CCT=0.98 vs. TEE\u2009=\u20090.67, p\u2009=\u20090.001). Adding CCT to TEE improved the detection and exclusion of abscess\/pseudoaneurysms, although results should be interpreted cautiously due to the sample size. The combination increased sensitivity at the expense of a small reduction in specificity, achieved a NPV of 100% and increased diagnostic confidence in physicians, supporting CCT as complementary imaging. The greatest benefit was for pseudoaneurysms, where TEE\u2009+\u2009CCT identified all and significantly improved AUC, whereas the overall improvement was less pronounced when abscesses were included. Given the rarity of these complications and the limited sample size, larger prospective studies are warranted to confirm these findings.<\/jats:p>","DOI":"10.1007\/s10554-026-03829-z","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:31:40Z","timestamp":1789659100000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The diagnostic value of additional ECG-gated CT for the diagnosis of aortic valve endocarditis with aortic root abscesses and pseudoaneurysms: A comparison with transoesophageal echocardiography and intraoperative findings"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9998-4259","authenticated-orcid":false,"given":"Thea","family":"Stybe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauge","family":"\u00d8stergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0455-4409","authenticated-orcid":false,"given":"Amna","family":"Alhakak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9742-1554","authenticated-orcid":false,"given":"Klaus Fuglsang","family":"Kofoed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f8rgen Tobias","family":"K\u00fchl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Ward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sune","family":"Damgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morten","family":"Smerup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper James","family":"Linde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Fosb\u00f8l","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"3829_CR1","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1093\/ehjqcco\/qcac011","volume":"9","author":"AD Jensen","year":"2022","unstructured":"Jensen AD, \u00d8stergaard L, Petersen JK, Graversen PL, Butt JH, Hadji-Turdeghal K, Dahl A, Bruun NE, Iversen K, Bundgaard H, K\u00f8ber L, Fosb\u00f8l EL (2022) Temporal trends of mortality in patients with infective endocarditis: a nationwide study. 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Dr. L.\u00d8. reports receiving an independent research grant from the Novo Nordisk Foundation. Dr. E.F. reports receiving independent research grants from the Novo Nordisk Foundation, the Danish Heart Association, and the Ministry of Health. Dr. K.F.K. reports receiving research grants from the A.P. M\u00f8ller Foundation, the Novo Nordisk Foundation, Sygeforsikringen Danmark, Novo Nordisk A\/S, Canon Medical Systems, and GE Healthcare. Dr. L.K. reports having received speaking horoarium from Astra Zeneca, Boehrigner, Novartis and Novo Nordisk. None of these funding sources are related to the present work. All other authors declare that they have no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}