Advantages of 3D Echocardiography in the Diagnosis of Mitral Valve Endocarditis and its Cardiac Complications

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. 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.