One hundred and one consecutive patients with infectious endocarditis were examined by transthoracic (TTE) and transoesophageal echocardiography (TEE). There were 71 cases of endocarditis on native valves (N) and 30 cases of endocarditis on prosthetic valves (P). The detection of vegetations was significantly greater by TEE (93%), than by TEE (73%) on native valves but the rate of detection of endocarditis on prosthetic valves was low and identical with bothy methods.Out of a total of 18 abscesses, only 6 were detected by TEE compared with 15 by TEE. There ware 3 false negative results by TEE : small anterior abscesses marked by the prosthesis or aortic calcifications.In addition, TEE demonstrated 3 perforations and 2 mycotic aneurysms of the mitral valve. The lesions were confirmed anatomically in 48 cases. The sensitivity of TEE was 94% and the specificity was 84.5%; the negative predictive value was 87.5%.These results show that TEE is significantly superior in the detection and morphological analysis of vegetations. It is the method of choice for the diagnosis of abscesses, especially in prosthetic valve endocarditis.

The mechanisms of the motion of the intimal flap and of thrombus formation in acute or chronic aortic dissection are not definitively elucidated. Transesophageal echocardiography seems to be a technique of choice to analyze the flow in the true and false lumina. Twenty‐one consecutive patients were studied in order to define the mobility of the intimal flap, the color Doppler flow patterns, the presence of spontaneous echocardiographic contrast, and thrombus formation at different levels of the aorta. The results suggest that clotted false lumen is more often seen in chronic aortic dissection at the level of the descending thoracic aorta. However, thrombosed false lumen in the aortic arch is suggestive of a retrograde aortic dissection. In cases of complete obliteration of the false lumen, the differentiation between aortic dissection and aortic ectasia with mural thrombus may be extremely difficult.

One hundred and one consecutive patients with infectious endocarditis were examined by transthoracic (TTE) and transoesophageal echocardiography (TEE). There were 71 cases of endocarditis on native valves (N) and 30 cases of endocarditis on prosthetic valves (P). The detection of vegetations was significantly greater by TEE (93%), than by TEE (73%) on native valves but the rate of detection of endocarditis on prosthetic valves was low and identical with both methods. Out of a total of 18 abscesses, only 6 were detected by TEE compared with 15 by TEE. There were 3 false negative results by TEE: small anterior abscesses marked by the prosthesis or aortic calcifications. In addition, TEE demonstrated 3 perforations and 2 mycotic aneurysms of the mitral valve. The lesions were confirmed anatomically in 48 cases. The sensitivity of TEE was 94% and the specificity was 84.5%; the negative predictive value was 87.5%. These results show that TEE is significantly superior in the detection and morphological analysis of vegetations. It is the method of choice for the diagnosis of abscesses, especially in prosthetic valve endocarditis.

The aim of this study was to evaluate the results of transesophageal echocardiography in the diagnosis of abnormal intraatrial echoes detected by transthoratic echocardiography. Patients with active endocarditis, mitral stenosis, and valve prostheses were excluded. The 47 patients (28 women and 19 men) were classified into 4 groups according to the results of transesophageal echocardiography.- Group I: normal (7 cases), "phantom echos"; - Group II: anatomical variants (9 cases), Chiari apparatus, muscular spur; - Group III: pseudo-tumours (7 cases); retroatrial haematoma, mitral valve prolapse, interatrial septal aneurysm; - Group IV: cardiac masses (24 cases). This group comprises: . typical myxomas (10 cases), . typical thrombi (2 cases), . localised atypical masses, relatively immobile and nonprolapsing: 5 myxomas, 1 metastasis, 2 thrombi.The results of this study suggest that transesophageal echocardiography is very useful in diagnosing suspected abnormal intraatrial echos observed on conventional transthoracic examination. However, the nature of the mass may remain obscure.

The aim of this study was to evaluate the results of transesophageal echocardiography in the diagnosis of abnormal intraatrial echoes detected by transthoracic echocardiography. Patients with active endocarditis, mitral stenosis, and valve prostheses were excluded. The 47 patients (28 women and 19 men) were classified into 4 groups according to the results of transesophageal echocardiography. Group I: normal (7 cases), "phantom echos"; Group II: anatomical variants (9 cases), Chiari apparatus, muscular spur; Group III: pseudo-tumours (7 cases); retro-atrial haematoma, mitral valve prolapse, interatrial septal aneurysm; Group IV: cardiac masses (24 cases). This group comprises: typical myxomas (10 cases), typical thrombi (2 cases), localised atypical masses, relatively immobile and non-prolapsing: 5 myxomas, 1 metastasis, 2 thrombi. The results of this study suggest that transesophageal echocardiography is very useful in diagnosing suspected abnormal intraatrial echos observed on conventional transthoracic examination. However, the nature of the mass may remain obscure.

The aim of this study was to analyse the velocity profile of the systolic fraction of the pulmonary venous flow (PVF) in mitral regurgitation (MR). Three velocity profiles were identified in left superior pulmonary vein. Inversion of the systolic fraction of the PVF was specific for angiographic grade 4 MR (specificity 97%, sensitivity 100%). On the other hand, a decrease in this wave is much less specific for mild MR and depends on severe factors such as left atrial pressure, size and ejection fraction and the lack of atrial systole (as in atrial fibrillation or atrioventricular block). Therefore, inversion of PVF has a good positive predictive value for severe MR, but the interpretation of attenuation of this wave should take into consideration not only the MR but also left atrial pressure and compliance.