[The echocardiographic study in 13 cases with infective endocarditis (author's transl)]

The echocardiographic study was performed in 13 cases with infective endocarditis including one case with annular subvalvular left ventricular (LV) aneurysm. The echocardiographic findings were compared with clinical as well as anatomical findings obtained by surgery or autopsy. The valvular vegetations were visualized echocardiographically in 6 cases (46%); 2 cases in aortic valve (AV), 2 in mitral valve (MV) and 2 in both valves. In 3 out of 4 cases with AV vegetation, the abnormal echo was seen in the LV outflow tract. Two out of these 3 cases indicated "flail aortic leaflet" with early closure of the MV, and immediate aortic valve replacement was performed. Unfortunately, one died 4 weeks after operation. The echocardiographic findings showed good correlation with anatomical findings in 4 cases with valve replacement. Out of 4 cases with MV vegetation, one developed the progressive growth with subsequent rupture of the chordae tendinae to the anterior mitral leaflet, which paralleled to the clinical deterioration. In another one case, the echocardiographic size of vegetation in the MV reduced significantly shortly after the episode of cerebral embolism. In a case of annular subvalvular LV aneurysm possibly due to infective endocarditis, echo free space was visualized in the interventricular septum, coinciding well with postmortem anatomical findings. It seemed to be reasonable to indicate surgical repair in cases with evident vegetation and considerable destruction of AV, in which congestive heart failure inevitably develops and the prognosis is poor.