Echocardiographic and surgical correlations in bacterial endocarditis.

The results of preoperative echocardiography were compared with the pathologic findings at the time of surgery in 24 patients undergoing valve surgery for endocarditis. Of the 32 valves involved by vegetations, 27 (84%) were identified preoperatively. Valve destruction was correctly predicted in 16 of 18 cases. Myocardial abscess formation was detected in only one of the five patients in whom it occurred. Overall, the echocardiograms satisfactorily predicted the pathologic anatomy in 20 cases. In the remaining four patients, the echocardiographic description was seriously incomplete or misleading. Thus, surgery can be recommended on the basis of the clinical and echocardiograhic findings for patients with endocarditis. Cardiac catheterization is reserved for patients in whom significant coronary artery disease or intracardiac shunts are suspected or in whom a satisfactory echocardiogram cannot be obtained.