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Detection of endocarditis-associated perivalvular abscesses by two-dimensional echocardiography
Journal of the American College of Cardiology
|March 1, 1985
Summary
Perivalvular abscesses complicating infective endocarditis are hard to detect noninvasively. Echocardiography can help identify abscesses using specific findings like prosthetic valve rocking, aiding surgical planning.
Area of Science:
- Cardiology
- Medical Imaging
- Infectious Diseases
Background:
- Perivalvular abscesses are serious complications of infective endocarditis.
- Noninvasive diagnostic techniques often fail to detect these abscesses.
Purpose of the Study:
- To compare two-dimensional echocardiographic findings in patients with and without perivalvular abscess.
- To identify echocardiographic predictors of perivalvular abscess in infective endocarditis.
Main Methods:
- Retrospective, blinded study comparing echocardiograms of 22 patients with perivalvular abscess to 24 controls.
- Analysis of 46 valves (aortic, mitral, prosthetic, native) within 0-7 days of surgery or necropsy.
Main Results:
- Patients with perivalvular abscess had significantly higher rates of severe complications (63% vs. 35%).
- No single echocardiographic finding was consistently present.
- A combination of prosthetic valve rocking, sinus of Valsalva aneurysm, or specific aortic root/septal thickening predicted abscess with 86% positive and 87% negative predictive values.
Conclusions:
- Specific echocardiographic findings can aid in the diagnosis of perivalvular abscess in infective endocarditis.
- These findings may assist surgeons in anticipating abscess presence before operation.