Evaluation of endocarditis and its complications by biplane and multiplane transesophageal echocardiography

Echocardiography is currently the method of choice for the diagnosis of endocarditis-associated vegetations or complications such as abscess formation. Thereby, the transesophageal approach (TEE) is clearly superior to precardial echocardiography and, at present, biplane TEE can be considered as the standard TEE technique. Compared with the monoplane technique, biplane TEE provides additional qualitative and quantitative information concerning the presence and amount of valvular destruction. Multiplane TEE facilitates (and abbreviates) the examination procedure, and may be helpful for easier detection of small initial abnormalities, those developing on native valves with preexisting lesions, or on prosthetic valves. It allows more accurate measurements and three-dimensional reconstruction of vegetations and abscess areas and provides more anatomical details of the disease. However, it remains to be shown by future studies if multiplane TEE will identify endocarditis-associated lesions more frequently than the biplane technique doses.