Transesophageal echocardiography in the study of infected valve prostheses

UNLABELLED: Prosthetic valve endocarditis is considered to be associated with more severe prognosis than native valve endocarditis due to inappropriate visualization of vegetations in prosthetics valves by transthoracic echocardiography. OBJECTIVE: The aim of this study was to describe our experience in prosthetic valve endocarditis and compare our results with those published in the literature. The valve of transesophageal approach in the detection of vegetations and complications associated with endocarditis was also assessed. RESULTS: 30 patients with infective endocarditis of prosthetic valve were studied between 1990 and 1997. The infection was located in prosthetic mitral valve in the 70% of the patients, in the aortic prosthetic valve in 24% and in pulmonary valve in one case. Transoesophageal echocardiography showed only vegetations in 22 patients, vegetations complicated with abscess in six patients and only abscess in 2 patients. In 70% of patients (21) surgical treatment was performed and the 30% (9 patients) received only medical treatment. CONCLUSIONS: Prosthetic valve endocarditis carries worse prognosis than native valve endocarditis, with mortality near 23%. Transoesophageal echocardiography is the indicated approach in the diagnosis of prosthetic valve endocarditis.