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The use of positron emission tomography imaging with 18F-fluorodeoxyglucose in diagnosing patients with suspected prosthetic valve endocarditis and cardiac device infection (implantable electronic device and left ventricular assist device) is gaining momentum in clinical practice. However, in the absence of prospective randomized trials, guideline recommendations about 18F-fluorodeoxyglucose positron emission tomography in this setting are primarily based on expert opinion. Measurement of aortic valve microcalcification as a healing response to valvular inflammation using 18F-sodium fluoride positron emission tomography represents another promising clinical approach associated with the risk of native valve stenosis progression and bioprosthetic valve degeneration in research trials. This review considers the role of molecular imaging in cardiac valvular diseases, including aortic stenosis and valvular endocarditis, as well as cardiac device infections.
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