Three-dimensional transesophageal echocardiographic imaging of mitral valve bioprosthesis leaflets perforation due to infective endocarditis

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Three-dimensional transesophageal echocardiographic imaging of mitral valve bioprosthesis leaflets perforation due to infective endocarditis

Marcelo Luiz Campos Vieira; Pablo M. A. Pommerantzeff; Carlos M. Brandão; Max Grinberg; Wilson Mathias Junior; José A. F. Ramires

Instituto do Coração do Hospital das Clínicas – FMUSP - São Paulo, SP, Brazil

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Key words: Echocardiography, three-dimensional; echocardiography, transesophageal; heart valve prosthesis; endocarditis.

Echogardiographic aspects have been added to the criteria used to investigate the diagnosis of infective endocarditis¹. However, under some circumstances, the two-dimensional echocardiographic technique, whether transthoracic or transesophageal, fails to provide sufficient diagnostic information. We report the case of a 43-year old patient with a biological prosthesis in the mitral position, who presented an episode of infective endocarditis with positive blood cultures for Staphylococcus aureus. The patient underwent two-dimensional transthoracic and transesophageal echocardiographic investigation and later to three-dimensional transesophageal reconstruction. The perforation of the leaflets of the bioprosthesis was evidenced only after the three-dimensional echocardiographic analysis was carried out (Figure 1). The patient underwent bioprosthesis replacement, and discharged from hospital seven weeks after the surgery. Three-dimensional echocardiography adds diagnostic information as it allows the study of the heart from multiplane structural observation^2,3.

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

References

1. Durack DT, Lukes A S, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Am J Med. 1994; 96: 200-9.

2. Gunasegaran K, Yao J, De Castro S, Nesser HJ, Pandian NG. Three-dimensional transesophageal echocardiography (TEE) and other future directions. Cardiol Clin. 2000; 18: 893-910.

3. Hozumi T, Yoshikawa J. Three-dimensional echocardiography using a multiplane transesophageal probe: the clinical applications. Echocardiography. 2000; 17: 757-64.

Manuscript received October 28, 2005; revised manuscript received October 28, 2005; accepted October 28, 2005.

Publication Dates

• Publication in this collection
  07 Mar 2007
• Date of issue
  Jan 2007