The role of transesophageal echocardiography in patients with chronic renal failure at low and high risk of endocarditis

Background and aims of the study: The benefits of transesophageal echocardiography (TEE) may depend on the clinical likelihood of infective endocarditis, but little data exist on patients at low risk. Methods and Results: We studied 32 patients with renal failure with either a low (n = 21) or high (n = 11) level of clinical suspicion for infective endocarditis. In the low-risk cases, TEE provided no new information whether the transthoracic echo was normal or abnormal, although it did confirm that an echogenic mass was more likely to be a calcific deposit than a vegetation. In the high-risk cases, transthoracic echocardiography was always abnormal but TEE added new information in seven out of 11 cases - positively in six, and by exclusion in one. TEE detected signs of complications of infective endocarditis in one case.Conclusions: We conclude that, when the clinical suspicion of endocarditis is low, TEE is rarely necessary.