treating team for clinical indications. All TTEs were performed by
using Hewlett Packard Sonos 5500 machines (Hewlett Packard,
Andover, MA) with 2- to 12-MHz phased-array transducers. Twodimensional
imaging from multiple tomographic planes and spectral
Doppler and color-flow imaging were used in all patients.
Images were recorded on 1⁄2-in super-VHS videotape and in digital
full-screen cine loop display format (EnConcert, Andover, MA).
Findings consistent with IE included vegetation, abscess, new
valvular regurgitation, and otherwise unexplained valvar dysfunction
as defined previously.6 A vegetation (Fig 1) was defined
as an irregularly shaped echogenic mass adherent to a valve or
endothelial surface. Characteristics used to identify a vegetation
included oscillating motion (high-frequency movement independent
from associated valvar motion), mobility (exceeding and
independent of the associated valve structure) and shaggy or
irregular surfaces. An abscess was defined as a thickened area or
mass within the myocardium or annular region, characterized by
an irregular, nonhomogeneous echogenic appearance. Other unexplained
valvular abnormalities consistent with IE included new
valvular regurgitation at least moderate in severity or destruction
or perforation of valve tissue
treating team for clinical indications. All TTEs were performed byusing Hewlett Packard Sonos 5500 machines (Hewlett Packard,Andover, MA) with 2- to 12-MHz phased-array transducers. Twodimensionalimaging from multiple tomographic planes and spectralDoppler and color-flow imaging were used in all patients.Images were recorded on 1⁄2-in super-VHS videotape and in digitalfull-screen cine loop display format (EnConcert, Andover, MA).Findings consistent with IE included vegetation, abscess, newvalvular regurgitation, and otherwise unexplained valvar dysfunctionas defined previously.6 A vegetation (Fig 1) was definedas an irregularly shaped echogenic mass adherent to a valve orendothelial surface. Characteristics used to identify a vegetationincluded oscillating motion (high-frequency movement independentfrom associated valvar motion), mobility (exceeding andindependent of the associated valve structure) and shaggy orirregular surfaces. An abscess was defined as a thickened area ormass within the myocardium or annular region, characterized byan irregular, nonhomogeneous echogenic appearance. Other unexplainedvalvular abnormalities consistent with IE included newvalvular regurgitation at least moderate in severity or destructionor perforation of valve tissue
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