Usefulness of transesophageal echocardiography for diagnosis of infected transvenous permanent pacemakers
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1994
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Lippincott, Williams & Wilkins / American Heart Association
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Vilacosta I, Sarriá C, San Román JA, Jiménez J, Castillo JA, Iturralde E, Rollán MJ, Martínez Elbal L. Usefulness of transesophageal echocardiography for diagnosis of infected transvenous permanent pacemakers. Circulation. 1994 Jun;89(6):2684-7. doi: 10.1161/01.cir.89.6.2684.
Abstract
Se sabía que la ecocardiografía transesofágica es más eficaz que la ecocardiografía transtorácica para detectar vegetaciones en los cables de marcapasos permanentes transvenosos infectados. Sin embargo, no existían datos sobre el valor de la ecocardiografía transesofágica en el diagnóstico de marcapasos permanentes transvenosos infectados. En el estudio, realizado a 10 pacientes con sospecha clínica de infección, la ecocardiografía transtorácica detectó vegetaciones en 2 pacientes, mientras que la transesofágica las visualizó en 7. La confirmación quirúrgica se obtuvo en 6 de estos 7 casos. La mayoría de los pacientes tenía múltiples electrodos de marcapasos y presentaron complicaciones locales en el bolsillo del generador. El Staphylococcus fue el microorganismo más frecuente. Estos resultados demuestran que la ecocardiografía transesofágica es superior para la identificación de vegetaciones en marcapasos
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 suspicion of infected permanent transvenous pacemakers. Transthoracic echocardiography detected pacemaker lead vegetations in 2 patients, whereas transesophageal echocardiography visualized pacemaker lead vegetations in 7 patients. Surgical confirmation was obtained in 6 of these 7 patients. Most patients had more than one pacemaker electrode in place. Local complications at the generator pocket were present in 6 patients. Staphylococcus was the predominant causative organism. Conclusions: Transesophageal echocardiography is superior to transthoracic echocardiography in the detection of pacemaker lead vegetations.
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 suspicion of infected permanent transvenous pacemakers. Transthoracic echocardiography detected pacemaker lead vegetations in 2 patients, whereas transesophageal echocardiography visualized pacemaker lead vegetations in 7 patients. Surgical confirmation was obtained in 6 of these 7 patients. Most patients had more than one pacemaker electrode in place. Local complications at the generator pocket were present in 6 patients. Staphylococcus was the predominant causative organism. Conclusions: Transesophageal echocardiography is superior to transthoracic echocardiography in the detection of pacemaker lead vegetations.