1991
DOI: 10.1055/s-2007-1019985 View full text |Buy / Rent full text
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Abstract: The object of the study was to follow patients with endocarditis-associated abscesses in order to evaluate the clinical outcome with and without surgical intervention. Transesophageal echocardiography successfully displayed the location and extent of abscess cavities in 14 patients (group A) with aortic valve endocarditis. The infective process was limited to the perivalvular tissue in two, extended into the ascending aorta in six, and included the interventricular septum, the right ventricular outflow tract, … Show more

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“…101 The anatomic vulnerability of this area explains both why abscesses occur in this location and why heart block is a frequent sequela. 28,102 Periannular extension is common, occurring in 10% to 40% of all native-valve IE, and complicates aortic IE more commonly than mitral or tricuspid IE. 82,103,104 Periannular infection is of even greater concern with prosthetic-valve IE, occurring in 56% to 100% of patients.…”
Section: Periannular Extension Of Infectionmentioning
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“…101 The anatomic vulnerability of this area explains both why abscesses occur in this location and why heart block is a frequent sequela. 28,102 Periannular extension is common, occurring in 10% to 40% of all native-valve IE, and complicates aortic IE more commonly than mitral or tricuspid IE. 82,103,104 Periannular infection is of even greater concern with prosthetic-valve IE, occurring in 56% to 100% of patients.…”
Section: Periannular Extension Of Infectionmentioning
“…32 The sensitivity of TEE can be further improved by imaging in Ն2 planes, because incremental planes decrease the number of false-negative studies and improve the definition of vegetation extent and mobility. 28 The excellent performance of TEE makes it the method of choice in the diagnosis of IE in patients who are difficult to image, in possible prosthetic-valve IE, in patients with intermediate or high clinical suspicion of IE, and in those patients with a high risk for IE-related complications (Table 4). One recently published study comparing TTE and TEE in patients with S aureus bacteremia (SAB) found TEE was essential to establish a diagnosis of IE and to detect associated complications.…”
Section: Echocardiographymentioning
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“…244,245 TEE dramatically improves sensitivity for defining periannular extension of IE (76% to 100%) while retaining excellent specificity (95%) and positive and negative predictive values (87% and 89%, respectively). 49,246 When combined with spectral and color Doppler techniques, TEE can demonstrate the distinctive flow patterns of fistulae and pseudoaneurysms and can rule out communications from unruptured abscess cavities. Because of these combined capabilities, TEE is the modality of choice for the initial assessment of any patient suspected of having perivalvular extension of IE (Class I, Level of Evidence: A).…”
Section: Periannular Extension Of Infectionmentioning