title: Limitations and discrepancies of transthoracic and transoesophageal echocardiography compared with surgical findings in patients submitted to surgery for complications of infective endocarditis.
abstract: OBJECTIVE
  Transoesophageal echocardiography (TEE) is recognized to be superior to transthoracic echocardiography (TTE) in evaluating complications of infective endocarditis (IE). The aim of this study was to compare results from TTE and TEE with surgical findings, and to assess limitations and discrepancies of TEE as compared with surgical findings.
  
  
  METHODS
  A retrospective analysis was carried out in 63 consecutive patients undergoing surgical intervention for IE-related complications. All patients were submitted to TTE and TEE before surgery. Clinical, anaesthesiological and surgical data were reviewed for all patients as well as the TTE and TEE examinations recorded on S-VHS videotape. Patients were divided into two groups according to the time elapsed from TEE to surgery (> 72 h in group A and < 72 h in group B).
  
  
  RESULTS
  The study population included 44 patients with native valve endocarditis and 19 patients with prosthetic valve endocarditis for a total of 76 affected valves (54 native and 22 prosthetic valves). No significant differences were observed between groups in number of patients (31 vs. 32; P = NS), of native valves (29 vs. 27; P = NS), and of prosthetic valves (10 vs. 12; P = NS). Discrepancies between TEE and surgical findings were found in 14 cases (11/31 in group A vs. 3/32 in group B; P = 0.01).
  
  
  CONCLUSIONS
  Time between TEE and surgery seems to be an important factor affecting comparison. Lesion characteristics appear to be more precise and concordant with surgical findings the shorter the time elapsed from TEE to surgery. Changes resulting from disease progression require repeat TEE evaluation prior to surgical intervention for IE-related complications. This could be useful in providing the surgeon with a more accurate definition of valvular lesions for optimal planning of intervention.
authors.affiliation: Division of Cardiology, Civic Hospital, Castiglione delle Stiviere (MN), Italy.
authors.forename: Catia
authors.initials: C
authors.lastname: Cicioni
authors.forename: Vittorio
authors.initials: V
authors.lastname: Di Luzio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Di Emidio
authors.forename: Franco
authors.initials: F
authors.lastname: De Remigis
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fragassi
authors.forename: Renato
authors.initials: R
authors.lastname: Gregorini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mazzola
authors.forename: Saro
authors.initials: S
authors.lastname: Paparoni
authors.forename: Franco
authors.initials: F
authors.lastname: Prosperi
authors.forename: Claudio
authors.initials: C
authors.lastname: Ferri
mesh_terms: D000038:Abscess / Q000209:etiology / Q000601:surgery; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000382:microbiology; D018450:Disease Progression; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color