[Role of transesophageal echocardiography in infectious endocarditis]

The role of transoesophageal echocardiography in infective endocarditis is detailed after concisely restating the precautions required by this examination. The diagnosis is nowadays based on the Duke University criteria, the major echocardiographic criteria being a typical image of vegetation, of abscess or of prosthetic valve dehiscence. The assessment of the complications includes the evaluation of the extent of destruction of the valvar or intracardiac structures and its hemodynamic consequences, the occurrence of a pericarditis and the assessment of the embolic risk. The different pitfalls and limitations of the examination are considered. The indications for repeating transoesophageal echocardiography during follow-up are considered, based on recently published recommendations. The respective advantages of the transthoracic and the transoesophageal approach are discussed, with a special focus on right heart endocarditis.