Key result
3D-TEE outperforms 3D-TTE with ~88% sensitivity for diagnosing mitral valve endocarditis vegetations.
Why the study?
Endocarditis of the heart valves can induce numerous severe complications, and ultrasonic imaging has assumed increasing importance as a major Duke diagnostic criterion for detecting native mitral valve vegetations and guiding surgical management.
Does 3D echocardiography (3D-TTE and 3D-TEE) improve the diagnostic detection and anatomical assessment of mitral valve vegetations and complications compared to 2D echocardiography in patients with mitral valve infective endocarditis?
Does 3D echocardiography (3D-TTE and 3D-TEE) improve the diagnostic detection and anatomical assessment of mitral valve vegetations and complications compared to 2D echocardiography in patients with mitral valve infective endocarditis?
3D echocardiography (both TTE and TEE) complements 2D echocardiography by providing superior spatial orientation and anatomical detail for diagnosing mitral valve infective endocarditis, assessing structural complications, and guiding surgical or transcatheter repair.
Answers are grounded in this paper and cite their sources.
May favor 3D-TEE over 3D-TTE for mitral vegetation detection; leaves open incremental benefit versus 2D and impact on outcomes.
Background: Endocarditis (E) (i.e. an infection of the endocardial surface) can involve heart valves (native or prosthetic) or the mural endocardium and can induce numerous and heavy complications. Keywords: Mitral valve infective endocarditis; 3D echocardiography; cardiac complications and surgical correction.Methods: The Duke diagnostic criteria are used to make the diagnosis of infective (E).These combine the clinical, pathologic, microbiologic and echocardiographic aspects.Echocardiography plays a key role and was considered as a major Duke criteria for diagnosis of infective E. Particularly, ultrasonic method has assumed an increasing importance for the diagnosis of valves' E.Results: We only evaluated the importance of 3D-Echocardiography (3D-E), both from trans-thoracic (TTE) and trans-esophageal (TEE) view, in the detection of native mitral valve vegetation's by E, their pre-surgical complications and post-surgical aspects.Conclusions: 3D-TTE and TEE, significantly increased the diagnosis of mitral infective E and vegetations, even when the blood culture are negative.In particular, 3D-E (TTE and TEE) appear useful in defining pre-surgical findings of mitral E, the exact location of leflets' vegetations, their size and shape and the post-procedural assessment.Thus, 3D-E findings represent an effective advancement in comparison with previous echocardiographic techniques.
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Fulvio Cacciapuoti (2018) conducted a review in Mitral valve infective endocarditis. 3D Echocardiography (3D-TTE and 3D-TEE) vs. 2D Echocardiography (2D-TTE and 2D-TEE) and M-mode echocardiography was evaluated on Detection of mitral valve vegetations and pre-surgical complications. 3D transesophageal echocardiography demonstrates a sensitivity of 85-90% versus 75% for 3D transthoracic echocardiography in diagnosing mitral valve endocarditis vegetations.
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