Definitions of echocardiographic phenomena
- Asymptomatic masses on endocardial leads (AMEL) characterized by
homogeneous echogenicity, smooth contour and varying degrees of
organization. AMEL include components of connective tissue
(accretions), clots, masses resembling vegetations (so-called
vegetation-like masses). Vegetation-like masses may be the remnant
vegetations after antibiotic treatment or (less probable) organized
fibrotic thrombi [18].
- Hyperechoic segmental thickening of the leads defined as connective
tissue overgrowth (undergoing fibrosis, mineralization,
crystallization and even ossification) [18[.
- Bacterial vegetations: multishaped, mobile masses of inhomogeneous
echogenicity attached to the leads or/and to the neighboring anatomic
structures, most frequently tricuspid leaflets. They were found only
if they were accompanied by signs of a general infection. Sometimes
coexisting with AMEL (vegetation-like masses) [18].
- Accretion – immobile fibrous connective tissue sheath around the lead
causing adherence to the endocardium and vessel walls and producing
images similar to segmental lead thickening but moving along with the
cardiac wall [18].
- Excessive lead loops - result of too weak fixation of the lead during
implantation or lead fracture with break of insulation in the
subclavian region [18].
- Cardiac wall perforation by the lead: visualization of the lead tip
outside the heart contour, sometimes with fluid in the pericardial
sac; placement of the lead tip close to the border of the pericardium
is referred to as penetration [18].