[Infective Endocarditis: Problems of Diagnosis and Treatment]

Area of Science:

• Cardiology
• Infectious Diseases
• Surgical Pathology

Background:

• Infective endocarditis (IE) is a serious heart valve infection.
• Accurate diagnosis and timely surgical intervention are critical for managing IE.
• Non-invasive imaging plays a key role in presurgical assessment.

Purpose of the Study:

• To evaluate the diagnostic performance of integrated echocardiography in infective endocarditis.
• To assess the correlation between vegetation characteristics and embolic events.
• To determine the impact of echocardiography on surgical decision-making and outcomes in IE.

Main Methods:

• Clinical study of 458 patients with infective endocarditis.
• Utilized integrated echocardiography, including transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE).
• Results confirmed by intrasurgical revision and histological examination.

Main Results:

• Integrated echocardiography demonstrated high sensitivity for IE diagnosis (96-97.9% for primary IE).
• No correlation found between vegetation characteristics (size, location, shape, mobility) and embolic risk.
• Echocardiography facilitated accurate diagnosis, surgical necessity determination, and timely scheduling.

Conclusions:

• Integrated echocardiography is a principal non-invasive tool for diagnosing infective endocarditis.
• Surgery in active IE is indicated for high-risk patients or when antibiotic therapy is unlikely to succeed.
• Overall hospital mortality was 8.1%, with variations based on surgical timing relative to active infection.