Infective endocarditis in the era of intracardiac devices: an echocardiographic perspective

Although the role of echocardiography is well established in the management of native valve and prosthetic valve endocarditis, the recent introduction of intracardiac devices, including pacemakers, implantable defibrillators, closure devices, and ventricular assist devices, has expanded its utility. Echocardiography permits the direct imaging of valvular vegetations, and it allows for the identification of structural complications of endocarditis. It is useful for characterizing the hemodynamic consequences of the infection. It can also provide prognostic information concerning risk of embolization and/or need for cardiac surgery. This article reviews the roles of transthoracic echocardiography and transesophageal echocardiography in the evaluation of patients with native valve endocarditis, prosthetic valve endocarditis, and infections involving a variety of nonvalvular cardiovascular devices.