[Transesophageal echocardiography in infectious endocarditis].

During the past 20 years, TTE has acquired a role of choice in the positive diagnosis as well as in the prognostic evaluation of endocarditis. However, it is a non-histobacteriological technique and is also operator-dependent. If often enables the detection of high risk patients: large vegetations, severe valve damage with major leaks, threatened complications: abscess, fistula, sometimes leading to referral of the patient for emergency surgery when required by hemodynamic conditions (often without recourse to catheterisation) or when infection is uncontrolled despite proper medical treatment. Embolism is the chief cause of morbidity and mortality in IE. In this context, the size of vegetations appears to be a risk factor. TEE enables refinement, precision and completion of TTE findings. It should be requested in the following circumstances: 1) strong clinical suspicion of IE but TTE negative, 2) monitoring of severe forms due to virulent organisms, 3) whenever there is suspicion of IE affecting a valve replacement.