Transesophageal echocardiography and endocarditis
Tingleff, J.; Egeblad, H.; Abildgaard, U.
Ugeskrift for Laeger 155(3): 166-170
1993
ISSN/ISBN: 0041-5782 PMID: 8421876 Document Number: 418255
In 49 patients (34 men and 15 women with an average age of 51 years, range 21-81 years) with a total of 51 episodes of suspected or already demonstrated endocarditis, the diagnostic and therapeutic value of transthoracic echocardiography (TTE) was compared with transoesophageal echocardiography (TEE). It was demonstrated by operation, autopsy, or the course of the condition, that endocarditis was present in 34 cases, while 17 patients did not have endocarditis. The correct diagnosis was established in 19 out 51 cases (37%) by TTE and in 44 (85%) cases by TEE (p < 0.05). The number of ambiguous investigation results fell significantly from 30 (58%) with TTE to seven with TEE. A total of 14 cases of cavity formation related to endocarditis, rupture of fistulae, or perivalvular leakage from prostheses occurred. Three (21%) of these complications were demonstrated by TTE while TEE demonstrated all 14. After examination with TEE, treatment of the patients was changed in 20 cases (39%). It is concluded that: 1) TEE can confirm or exclude the diagnosis of endocarditis with much greater certainty than TTE, 2) TEE more than halves the number of ambiguous results of investigation and 3) TEE multiplies recognition of complications of endocarditis. Even although the results from the cardiological/thoracic surgical centre cannot be transferred to the primary hospital just like that, the results of these and other investigations suggest that TEE should be carried out when TTE cannot confirm or exclude clinically suspected endocarditis with certainty.