Comparison of transesophageal to transthoracic color Doppler echocardiography in the identification of intracardiac mycotic aneurysms in infective endocarditis.
We report on cases of mycotic aneurysms in a group of 14 patients with infective endocarditis, all of whom were evaluated with transthoracic (TTE) and transesophageal (TEE) color Doppler echocardiography.  Four mycotic aneurysms were found, one each in the left ventricular outflow tract, the right coronary sinus of Valsalva, the anterior mitral leaflet, and the atrial septum.  With TTE, only three of four cases of mycotic aneurysms could be detected.  Utilizing TEE, however, all were detected and their connections with the heart chambers or great vessels could be readily and clearly depicted, especially those in the atrial septum and mitral leaflet.  We are of the opinion that TEE is superior to TTE in the identification and detailed analysis of mycotic aneurysms complicating infective endocarditis.  In addition, we feel that echocardiography may help evaluate the progress of the disease, the location and direction of infection, and the extent of involvement of the mycotic aneurysms, providing useful information for guiding surgical intervention.
Intensive Care Unit, Taichung Veterans General Hospital, Taiwan, Republic of China.
M N
MN
Kan
Y T
YT
Chen
A Y
AY
Lee
D000328:Adult; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging*; D015150:Echocardiography, Doppler / Q000379:methods*; D004696:Endocarditis / Q000150:complications / Q000000981:diagnostic imaging; D004947:Esophagus; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013909:Thorax