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

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 (F-18-FDG PET/CT) scan showed an area of hyper-uptake around the ascending aorta. We realized that the sheet of Surgicel (Ethicon, Bridge-water, 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 F-18-FDG PET/CT scan owing to local hemostatics should be considered when interpreting the findings of this technique. (C) 2021 by The Society of Thoracic Surgeons