The reliability of echocardiography in preoperative diagnostics of bacterial endocarditis

During a period of 4 years, 32 patients with acute bacterial endocarditis were admitted for cardiac surgical intervention. Uncontrollable infections, heart failure or embolism presented indications for the operation. In all cases, a preoperative, invasive angiography diagnostic was abandoned. The indication for surgical intervention was based on clinical criteria as well as the findings of one-dimensional or two-dimensional echocardiography. In 26 out of 32 patients who underwent surgical intervention, the preoperative echocardiography findings were in agreement with the intraoperative findings. In the remaining 6 patients, the preoperative echocardiographic findings were incomplete; in 2 cases particularly, it is important to note that an aneurysm of the ascending aorta had been missed. In view of these findings and results, we think that in acute bacterial endocarditis, the combined use of one- and two-dimensional echocardiography together with clinical findings can replace preoperative hemodynamic diagnostics.