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- W2017433766 abstract "Background: Cardiac device-related infective endocarditis (CDRIE) is increasingly encountered and associated with high morbidity and mortality. Few trials have assessed the diagnostic accuracy of modern-era transthoracic with transoesophageal echocardiography in patients undergoing lead explantation. Aim: To determine the diagnostic accuracy of TTE using modern era imaging for detection of CDRIE. Methods: Lead explant data was reviewed for cases of cardiac device infection (CDI) since 2002. Echocardiographic findings and blood cultures for each patient were analysed to identify cases of true CDRIE, to differentiate from isolated pocket-site infection. Results: 377patients underwent lead extraction (total of 684 leads) of which 142 were for CDI, and of those, 41 cases of CDRIE. Overall, CDRIE constituted 29% of all cases of CDI. Location of device lead vegetations were: within the RA [29/35], RV [5/35], SVC [1/35]. Mean vegetation size: 14mm x 6mm. Lead vegetations were associated with concomitant valve involvement in nine cases [26%], most commonly tricuspid valve [8/9]. Isolated valve involvement was seen mostly on TV [4/6 patients] with left-sided involvement being less common [AV-1/6; MV 1/6]. Main causative organisms were Staphylococcus aureus [34%] and Staphylococcus epidermidis [20%] with culture negative [5%]. Seventeen of 35 patients underwent both TTE and TOE, of which six had CDRIE correctly diagnosed on TTE. Overall, the sensitivity of TTE for detection of lead vegetations (with or without valvular involvement) was 37%. Conclusion: TTE alone is suboptimal to exclude CDRIE due to the low sensitivity and TOE should be considered in all patients with negative TTE and clinical suspicion of lead or valvular infection." @default.
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- W2017433766 date "2013-01-01" @default.
- W2017433766 modified "2023-09-27" @default.
- W2017433766 title "The Role of Modern-Era Transthoracic Echocardiography for Detection of Cardiac Device-Related Infective Endocarditis" @default.
- W2017433766 doi "https://doi.org/10.1016/j.hlc.2013.05.479" @default.
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