VALUE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN THE DIAGNOSIS OF INFECTIOUS ENDOCARDITIS - STUDY OF 125 CONSECUTIVE CASES

One hundred and twenty-five consecutive patients with infectious endoc arditis were examined by transthoracic (TTE) and transesophageal echoc ardiography (TEE). They included 91 cases of endocarditis on native va lves and 34 cases on prosthetic valves. The detection rate for vegetat ions was significantly greater (93%) by TEE than by TTE (73%) on nativ e valves, but the rate of detection of vegetations on prosthetic valve s was low and not significantly different between the two methods. Out of a total of 20 abscesses, only 8 were detected by TEE as compared w ith 17 by TEE, TEE gave three false negatives: small anterior abscesse s masked by a prosthesis or aortic calcifications. In addition, TEE vi sualized three perforations and three mycotic aneurysms of the mitral valve. The lesions were confirmed anatomically in 51 cases. Referring to the overall detection of vegetations and complications, TEE had a s ensitivity of 94% and a specificity of 84.5%, with a negative predicti ve value of 87.5%. These results show that TEE is significantly better than TTE for the detection and morphological analysis of vegetations and abscesses.