title: The important but underappreciated transgastric right ventricular inflow view for transesophageal echocardiographic evaluation of cardiac implantable device infections.
abstract: Device infection is a potential complication of cardiovascular implantable electronic devices. We report a case of a 40-year-old man with nonischemic cardiomyopathy, status post biventricular implantable cardiac defilbrillator placement on continuous home dobutamine, who presented with methicillin-resistant Staphylococcus aureus bacteremia. Transesophageal echocardiography showed a 2.4 cm vegetation near the right ventricular (RV) apex that was only seen in the transgastric RV inflow view. This case demonstrates an atypical distal location for a vegetation and illustrates the importance of obtaining multiple views, including the transgastric RV inflow view, when evaluating for device wire vegetations.
authors.affiliation: Wexner Medical Center at The Ohio State University, Columbus, Ohio, USA.
authors.forename: Clint
authors.initials: C
authors.lastname: Allred
authors.forename: Mark
authors.initials: M
authors.lastname: Crandall
authors.forename: Alex
authors.initials: A
authors.lastname: Auseon
mesh_terms: D000328:Adult; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004452:Echocardiography / Q000379:methods*; D004696:Endocarditis / Q000000981:diagnostic imaging* / Q000209:etiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging* / Q000209:etiology*