PubMed · 12218563
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Mark J Kulbieda, Theodore A Alston. 2002. Echo bib.. https://doi.org/10.1097/00000542-200209000-00058
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Embolic events are a frequent and life-threatening complication of subacute bacterial endocarditis (SBE), and are associated with a high mortality and morbidity. The prediction of the embolic risk in an individual patient remains a challenge. Echocardiography plays a key role in the management of infective endocarditis both for the diagnostic and prognostic assessment of these patients, but its value in predicting embolic events is still debated. This review focuses on the characteristics of embolic events in SBE, and on the role of echocardiography, especially transesophageal echocardiography (TEE), in the prediction of embolic events. The review confirms that, among other factors, TEE may be helpful in both the prediction of the embolic risk, and the decision to perform early surgery.
Our recent experience with an autologous pericardium strip to obtain an overreducing posterior mitral annuloplasty is reported. From March 2001 to May 2002, 31 patients underwent this procedure to correct functional (n = 19) or postischemic (n = 12) mitral regurgitation. The length of the pericardium strip was always 4 cm; mean final mitral area was 2.9 cm2, with a mean gradient of 2.9 mm Hg. Eight patients underwent a stress test. Mitral area increased from 3.1 to 3.6 cm2, and the mean gradient increased from 3.1 to 5.2 mm Hg. Residual mitral regurgitation was 0.5 and, when present, remained unchanged at the end of the stress. Overreducing posterior mitral annuloplasty by using a 4-cm pericardial strip gives reproducible results and is effective in correcting functional or postischemic mitral regurgitation. Residual mitral regurgitation, when present, remains stable after stress.