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Echocardiography, three-dimensional; echocardiography, transesophageal; heart valve prosthesis; endocarditis. Echogardiographic aspects have been added to the criteria used to investigate the diagnosis of infective endocarditis1. However, under some circumstances, the two-dimensional echocardiographic technique, whether transthoracic or transesophageal, fails to provide sufficient diagnostic information. We report the case of a 43-year old patient with a biological prosthesis in the mitral position, who presented an episode of infective endocarditis with positive blood cultures for Staphylococcus aureus. The patient underwent two-dimensional transthoracic and transesophageal echocardiographic investigation and later to three-dimensional transesophageal reconstruction. The perforation of the leaflets of the bioprosthesis was evidenced only after the three-dimensional echocardiographic analysis was carried out (Figure 1). The patient underwent bioprosthesis replacement, and discharged from hospital seven weeks after the surgery. Three-dimensional echocardiography adds diagnostic information as it allows the study of the heart from multiplane structural observation2,3.

Imagem ecocardiográfica transesofágica tridimensional de perfuração de folhetos de prótese biológica mitral em decorrência de endocardite infecciosa