Journal of Ultrasound in Medicine, Vol 9, Issue 6 319-323, Copyright © 1990 by American Institute of Ultrasound in Medicine
Echocardiographic detection of aortic valve ring abscesses
G. Russo, C. Tamburino, G. Greco, S. Tamburino, F. Privitera, C. Cinnirella, V. Calvi, A. Lomeo, M. Abbate and G. Giuffrida
Cattedra di Cardiochirurgia, Catania, Italy.
Valve ring abscess complication of infective endocarditis increases the
expected morbidity and mortality rates of patients, but is seldom
recognized by available noninvasive techniques. In our study,
two-dimensional echocardiography successfully detected valve ring abscesses
in eight patients with infective endocarditis affecting aortic valve
prosthesis. Echocardiography showed the perivalvular abscess as an
echo-free space in all patients. Prosthetic vegetations were seen in the
only patient who had a biological prosthesis and excessive prosthetic
rocking was observed in cases with severe aortic regurgitation. In two
patients, the first echocardiographic examination showed an echo-free space
without evident clinical signs of endocarditis or significant valve
regurgitation. Severe aortic insufficiency and congestive heart failure
followed the enlargement of the echo-free space. Valve replacement was
required in all but one patient. The echocardiographic findings were
confirmed at surgery. In one patient, the extension of the abscess to the
interventricular septum was not detected by the echocardiography.
