title: The Preoperative Evaluation of Infective Endocarditis via 3-Dimensional Transesophageal Echocardiography.
abstract: Transesophageal echocardiography continues to have a central role in the diagnosis of infective endocarditis and its sequelae. Recent technological advances offer the option of 3-dimensional imaging in the evaluation of patients with infective endocarditis. We present an illustrative case and review the literature regarding the potential advantages and limitations of 3-dimensional transesophageal echocardiography in the diagnosis of complicated infective endocarditis. A 51-year-old man, an intravenous drug user who had undergone bioprosthetic aortic valve replacement 5 months earlier, presented with prosthetic valve endocarditis. Preoperative transesophageal echocardiography with 3D rendition revealed a large abscess involving the mitral aortic intervalvular fibrosa, together with a mycotic aneurysm that had ruptured into the left atrium, resulting in a left ventricle-to-left atrium fistula. Three-dimensional transesophageal echocardiography enabled superior preoperative anatomic delineation and surgical planning. We conclude that 3-dimensional transesophageal echocardiography can be a useful adjunct to traditional 2-dimensional transesophageal echocardiography as a tool in the diagnosis of infective endocarditis.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Yong
authors.forename: Pankaj
authors.initials: P
authors.lastname: Saxena
authors.forename: Ammar M
authors.initials: AM
authors.lastname: Killu
authors.forename: Sean
authors.initials: S
authors.lastname: Coffey
authors.forename: Harold M
authors.initials: HM
authors.lastname: Burkhart
authors.forename: Siu-Hin
authors.initials: SH
authors.lastname: Wan
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Malouf
mesh_terms: D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012086:Reoperation; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Abscess/ultrasonography; echocardiography, three-dimensional/methods; echocardiography, transesophageal; endocarditis, bacterial/complications/diagnosis/therapy/ultrasonography; image enhancement/methods; imaging, three-dimensional/methods