We report three cases suffering from endocarditis caused by pacemaker lead infection. Because of the long interval beginning from implantation to surgical removal and the large vegetations on the leads, the entire pacemaker system was removed under extracorporeal circulation (ECC). Postoperative courses were uneventful and none of these patients have shown recurrent infection to date. The total...

Nine patients with anatomically documented vegetations on one or more cusps of the aortic valve had echocardiograms in which abnormal echoes were associated with the aortic leaflet echoes. The motion of the abnormal echoes during systole correlated well with the anatomic location of vegetations: a vegetation on the right coronary cusp moved anteriorly with systole while a vegetation on the nonc...

S UBACUTE bacterial endocarditis involves the left side of the heart in nearly all cases. The complete descriptions of the disease by Libman and Friedberg,’ Blumer,2 and Middleton and Burke3 refer chiefly to this common type. The vegetations are confined to the right side of the heart in less than 4 per cent of the cases.4*6 In patent ductus arteriosus complicated by subacute bacterial endarter...

Libman-Sacks endocarditis (LSE) is a common manifestation of valve disease in antiphospholipid syndrome. Mitral valve LSE is characterized by verrucous vegetations on the atrial surfaces of valve leaflets. In this report, mitral valve LSE was visualized by real time 3D transesophageal echocardiography (TEE). 3D TEE provides a unique en face view of the mitral valve akin to a surgical or autopsy...

Background Transesophageal echocardiography is superior to transthoracic echocardiography in detecting left-sided valvular vegetations. There are no data on the value of transesophageal echocardiography in the diagnosis of infected transvenous permanent pacemakers. Methods and Results Transthoracic and transesophageal echocardiography was performed in 10 patients for whom there was clinical sus...

Daptomycin is approved for treatment of Staphylococcus aureus bacteremia and right-sided endocarditis. Increases in daptomycin MICs have been associated with failure. A rabbit model of aortic valve endocarditis was used to determine whether MIC correlates with activity in vivo and whether a higher daptomycin dose can improve efficacy. Two related clinical S. aureus strains, one with a daptomyci...

The ability of a computer-based image digitizing system to differentiate "active" from "chronic" valvular vegetations was evaluated. Twenty-two patients with newly diagnosed infective endocarditis were studied prospectively by serial two-dimensional echocardiograms. Two comparable images (active and chronic) from the same patient taken several weeks apart (range, 4-17 weeks) after initiation of...