Valve ring abscess in infective endocarditis: visualization with wide angle two dimensional echocardiography.

Two dimensional echocardiography permitted visualization of a valve ring abscess complicating infective endocarditis in four patients. Abscess formation was defined as an echo-free cavity within tissues surrounding the infected valve. Abscess in the valve ring extended into the perivalvular structures, including the upper ventricular septum (one patient), left ventricular myocardium (one patient) and contiguous fibrous structures (three patients). Two dimensional echocardiography is the only noninvasive technique for direct visualization of the abscess cavity complicating infective endocarditis and may allow better appreciation of incidence, evolution and natural (or unnatural) course of this heretofore seldom recognized complication of infective endocarditis.