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Intraoperative two-dimensional echocardiography in complicated infective endocarditis of the aortic valve
Insights
Intraoperative two-dimensional echocardiography accurately visualized complex aortic valve endocarditis complications, aiding surgical decisions. This imaging technique is crucial for managing both native and prosthetic valve infections.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Infective endocarditis involving native or prosthetic aortic valves presents complex challenges.
- Accurate pre-operative and intra-operative assessment is vital for successful surgical management.
Purpose of the Study:
- To evaluate the efficacy of intraoperative two-dimensional echocardiography in visualizing pathological findings in complicated aortic valve endocarditis.
- To compare the diagnostic accuracy of intraoperative echocardiography with cineangiocardiography and precordial echocardiography.
Main Methods:
- Six patients with complicated native and prosthetic aortic valve endocarditis underwent surgery.
- Pre-operative cineangiocardiography and precordial two-dimensional echocardiography were performed.
- Intraoperative two-dimensional epicardial echocardiography was utilized before cardiopulmonary bypass.
- Echocardiographic findings were correlated with surgical and pathological results.
Main Results:
- Surgical inspection identified mycotic aneurysms in all six patients.
- Other findings included a right atrial fistula, interventricular septal abscess, and mitral valve endocarditis in one patient.
- Two-dimensional epicardial echocardiography correctly visualized all pathological conditions.
- Cineangiocardiography provided accurate information in one patient; precordial echocardiography was accurate in two patients.
Conclusions:
- Intraoperative two-dimensional echocardiography offers detailed and accurate visualization of complex pathologies in aortic valve endocarditis.
- This modality is highly valuable for surgical planning and management of complicated native and prosthetic aortic valve endocarditis.
Abstract:
Six patients with complicated native and prosthetic aortic valve endocarditis were operated on. The data from cineangiocardiography and from precordial and intraoperative two-dimensional echocardiography were compared with the surgical findings. Surgical inspection revealed a mycotic aneurysm in six patients. In addition, a fistulous connection to the right atrium, an abscess in the interventricular septum, and mitral valve endocarditis were found in one of the patients. The pathologic conditions disclosed during the operation were correctly visualized with two-dimensional epicardial echocardiography, done before cardiopulmonary bypass. Cineangiography provided this information in one patient, and precordial two-dimensional echocardiographic analysis was correct in two patients. Thus, intraoperative two-dimensional echocardiography provides detailed information in complicated native and prosthetic aortic valve endocarditis that is of importance in the surgical management.