Improved diagnostic value of echocardiography in patients with infective endocarditis by transoesophageal approach. A prospective study.

摘要: In a prospective study, the clinical value of transoesophageal two-dimensional echocardiography (TOE) as compared with transthoracic (TTE) was determined in patients suspected infective endocarditis. Ninety-six were studied consecutively an electronic sector scanner using 2–25 and 3–5 MHz probes for TTE probe embedded tip ofaflexible 12 mm gastroscope TOE. Results surgery autopsy available 20 96 endocarditis echocardiographically demonstrated vegetations 70 control valvular heart disease without no signs vegetations, who studiedpreoperatively TOE. For TOE, measured sensitivity 63% 100%, specificity 98% 98%, positive predictive accuracy 92% 95%, negative 91% respectively. 39 had blood cultures, found by TOE 32 (82%), but only 27 (69%) TTE. Image quality main factor contributing to superiority over TTE: it reduced 11/20 (55%) whom not detected Another important size vegetations. Only 6/24 (25%) 11 also observed The importance detecting rate embolism. embolism 25% when cultures 21% they negative. detectable seen patient 7% cultures. Evidence on aortic valve 14 mitral seven incompetence present, indicating that yet been damaged significantly. TOE is superior because better image quality, particularly are small. seems be indicated or results. Early detection valves may help confirm diagnosis at early stage hopefully lead improved prognosis reducing delay instituting appropriate therapy.