Scanning electron microscopy of infective endocarditis

As part of a study of the development of infective endocarditis in ncarcotic addicts, we sought to establish the feasibility of using scanning electron microscopy (SEM) to view the surface characteristics of human heart valves obtained at autopsy. Normal and infected heart valves from humans and animals were obtained at autopsy, fixed in formalin, and processed for SEM. Parallel samples from immediately adjacent regions were processed for light microscopy. Active and healed endocarditis were readily recognizable by SEM, and the observations correlated well with those made by light microscopy. The advantage of SEM in the study of endocarditis is that it provides significant information about damage to the endocardial surface across the entire valve. The relative proportions of fibrin, platelets, leukocytes, exposed stromal connective tissue and bacteria on the surface of a lesion can easily be analysed. SEM may prove particularly useful in the study of the pathogenesis of the early lesions of infective endocarditis on previously "undamaged" valves.