Currently, tricuspid valve infective endocarditis (TVIE) is encountered in daily clinical practice more frequently due to the increasing prevalence of illicit intravenous drug use and the implantation of intracardiac devices. In this study, we compared findings from intra-operative live/real time three-dimensional transesophageal echocardiograms (3DTEE) and two-dimensional transesophageal echocardiograms (2DTEE) of 10 patients who underwent surgery for native tricuspid valve (TV) endocarditis. Unlike 2DTEE, 3DTEE allowed en face visualization of the 3 TV leaflets from both, atrial and ventricular aspects, in 9 of the 10 cases. In the remaining patient, in whom 3DTEE could not identify all 3 leaflets en face, the TV was found essentially destroyed at surgery. Using 3DTEE, the number of vegetations was accurately reported when compared with the surgical record. Furthermore, the orientation of each vegetation was the same as noted in the surgical findings. 2DTEE missed the identification of vegetations in 5 patients. The attachment site of vegetations to the TV were also not characterized by 2DTEE in 5 patients. In all 10 cases, 3DTEE characterized the vegetations more accurately with larger dimensions, including those in the azimuthal axis, and volumes. In addition, a perivalvular abscess that lead to surgical intervention was identified by 3DTEE, however, missed by 2DTEE. In conclusion, 3DTEE allows en face visualization of the TV apparatus permitting accurate description of the number and dimensions of vegetations identified by our surgical standard, which ultimately informs patients' prognosis and dictates the timing and planning for surgical intervention. Its use should be in conjunction with 2DTEE when evaluating TVIE.

In this retrospective study, we identified 7 cases where Lambl's excrescences were identified by two-dimensional transesophageal echocardiography (2DTEE) and also had live/real time three-dimensional transesophageal echocardiography (3DTEE) studies available for comparison. We subsequently assessed them for the presence of Lambl's excrescences (LE) and nodules of Arantius (NA) on the aortic valve. After their identification, we qualitatively and quantitatively organized our findings by number, cusp location, measurements, and orientation if applicable. A greater number of LE was found by 3DTEE than 2DTEE (19 vs. 11, respectively). In all 3DTEE studies, their cusp attachment site, their x-, y-, and z-axis measurements, and orientation were clearly visualized and described. Only 3DTEE studies provided confident visualization of the cusp attachment sites. Similarly, a greater number of NA was found by 3DTEE than 2DTEE (21 vs. 5, respectively). The triad of NA was visualized in all 3DTEE studies and each was described using its x-, y-, and z- axis measurements. Only three 2DTEE studies provided reliable identification of the NA. In conclusion, we present further evidence of the incremental value of 3DTEE over 2DTEE in the qualitative and quantitative assessment of cardiac structures including LE and NA on the aortic valve.

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Results: 94 neonates were identified who had undergone fetal MRI in Sheffield and who had completed NHSP assessment. 32 of these babies had been admitted to a neonatal intensive care unit (NICU) and there was one case of congenital bilateral deafness among them. The national incidence of congenital hearing impairment detected by the NHSP is approximately 0.1%, rising to around 3% in NICU graduates. The incidence detected in babies following fetal MRI was 1% (95% confidence interval 0.0-5.8%), which is in accordance with the incidence expected given the high proportion of NICU graduates. For babies who were not admitted to NICU, there was no significant difference between their mean OAE cochlear response and the mean of a reference dataset of over 2000 OAE results from healthy babies. Conclusion: This study finds no significant excess clinical risk of permanent congenital hearing impairment as a result of magnetic resonance imaging during pregnancy. In addition, there was no evidence of impairment of frequency-specific cochlear response in healthy newborn babies who had been exposed to magnetic resonance imaging in utero. OP16.11Ultrasound transducer disinfection -an examination of cleaning and disinfection practices for surface and intracavity transducers R. Weinberger Nanosonics, Alexandria, NSW, AustraliaObjectives: To examine the problems with current methods of cleaning and disinfection of ultrasound transducers, including the need for less toxic chemicals for cleaning (particularly in assisted reproductive ultrasound clinics) and identify areas of need within ultrasound transducer reprocessing. Method: The study examined efficacy levels of existing ultrasound transducer cleaning and disinfection procedures and the role of a new process. All ultrasound transducers used in the department were swabbed and samples were taken and assessed following the use of current cleaning and/or disinfection procedures. The same transducers were then cleaned again and high level disinfected utilising a new process, after which another sample was taken. The cables of all transducers were also swabbed. All samples were plated and analysed for bacterial growth. The growth in each phase of the probe cleaning and disinfection were compared and then sent for analysis to determine bacteria type. Results: This study showed bacteria growth on intracavity transducers and large bacteria growth on surface ultrasound transducers and all the associated cables, even following the use of current reprocessing methods. In comparison the new method of high level disinfection for surface and intracavity transducers (that provides disinfection of the entire probe and handle area) demonstrated no discernible growth from samples. Conclusion: This study demonstrates the need to review the classification system for what transducers require high level disinfection, most significantly in regards to surface transducers, the area of the transducer that is disinfected, the methods used for disinfection and also the cleaning and maintenance of the trans...