Eustachian valve endocarditis (EVE) is a distinctly rare and underdiagnosed entity. We report 2 new cases caused
by vancomycin resistant Staphylococcus aureus and Staphylococcus hominis diagnosed on transesophageal
echocardiography (TEE). Although, 63% of Eustachian valve endocarditis is caused by Staphylococcus aureus,
we report the first case of vancomycin resistant Staphylococcus aureus and first case related to implantable
venous access systems. EVE is now seen more commonly in elderly population with diverse microbial cultures
and antibiotic sensitivities. TTE is the first modality for investigation of EVE, however a negative TTE does
not preclude the diagnosis, as only 88% of cases were diagnosed on TEE.
Key words: Echocardiography, endocarditis, Eustachian valve, transesophageal, vancomycin