title: The role of transesophageal echocardiography in patients with chronic renal failure at low and high risk of endocarditis.
abstract: OBJECTIVE
  The benefits of transesophageal echocardiography (TEE) may depend on the clinical likelihood of infective endocarditis, but little data exist on patients at low risk.
  
  
  RESULTS
  We studied 32 patients with renal failure with either a low (n = 21) or high (n = 11) level of clinical suspicion for infective endocarditis. In the low-risk cases, TEE provided no new information whether the transthoracic echo was normal or abnormal, although it did confirm that an echogenic mass was more likely to be a calcific deposit than a vegetation. In the high-risk cases, transthoracic echocardiography was always abnormal but TEE added new information in seven out of 11 cases-positively in six, and by exclusion in one. TEE detected signs of complications of infective endocarditis in one case.
  
  
  CONCLUSIONS
  We conclude that, when the clinical suspicion of endocarditis is low, TEE is rarely necessary.
authors.affiliation: Department of Cardiology, Guy's Hospital, London, UK.
authors.forename: E B
authors.initials: EB
authors.lastname: Wu
authors.forename: M L
authors.initials: ML
authors.lastname: Witherspoon
authors.forename: J D
authors.initials: JD
authors.lastname: Gillmore
authors.forename: J M
authors.initials: JM
authors.lastname: Pattison
authors.forename: J B
authors.initials: JB
authors.lastname: Chambers
mesh_terms: D004452:Echocardiography / Q000379:methods*; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D013290:Streptococcal Infections / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D015996:Survival Rate