Surgicel-Related Uptake on Positron Emission Tomography Scan Mimicking Prosthetic Valve Endocarditis

Abstract

A 78-year-old patient who underwent an aortic valve replacement presented 6 months later with clinical symptoms suspicious for prosthetic valve endocarditis. Echocardiography showed no features suggestive of endocarditis, but a positron emission tomography/computed tomography with fluorine-18-fluorodeoxyglucose (¹⁸F-FDG PET/CT) scan showed an area of hyper-uptake around the ascending aorta. We realized that the sheet of Surgicel (Ethicon, Bridgewater, NJ) hemostat had been placed over the aortotomy suture line at the time of surgery. Another follow-up PET/CT scan performed 22 months later showed that the hyper-uptake focus remained persistent. False-positive hyper-uptake on an ¹⁸F-FDG PET/CT scan owing to local hemostatics should be considered when interpreting the findings of this technique.