scholarly journals A rare case of anaerobic streptococci endocarditis in a young female with bicuspid aortic valve: case report

Author(s):  
Despina Toader ◽  
Mioara Cocora ◽  
Constantin Bătăiosu ◽  
Luminiă Ocroteală

Abstract Background Bicuspid aortic valve is the most common congenital cardiovascular malformation and occurs in 1–2% of the population. The haemodynamic changes appear early, leading to tissue damage and predisposing to germs attachment. The development of perivalvular extension is a constant in bicuspid aortic valve endocarditis. Infective endocarditis with anaerobic bacteria is a rare condition with a high rate of mortality. Case summary We report a case of a young female with bicuspid aortic valve infective endocarditis. Involved bacteria were anaerobic streptococci, and the clinical course of the diseases was very aggressive. The echocardiographic evaluation revealed aortic and mitral regurgitation, perivalvular abscess, ventricular septum defect, and pericardial effusion. The surgery approach consisted of the aortic valve replacement with a mechanical prosthesis after radical resection of aortic root abscess and reconstruction of the annulus. The ventricular septum defect was also closed with a pericardial patch. Anticoagulation started the first day after surgery. The patient was received antibiotic therapy for 10 days before and 4 weeks after surgical intervention. Evolution was very good at 1 and 6 months follow-up. Discussion This is a severe case of endocarditis, complicated with extensive valvular destruction, aortic root abscess, and fistula. Perivalvular complications are frequent in patients with bicuspid aortic valve endocarditis. The ‘take away’ message is that echocardiography is an essential tool for diagnosis, management, and follow-up of patients with infective endocarditis.

2020 ◽  
Vol 47 (4) ◽  
pp. 280-283
Author(s):  
Ahmed Ahmed ◽  
Ayman Ammar ◽  
Yasser Elnahas ◽  
Mohammed Abd Al Jawad

Aortic root abscess complicated by infective endocarditis of a mechanical prosthetic valve is associated with morbidity and death. We retrospectively report our experience with a valve-sparing technique for managing this condition. From October 2014 through November 2017, 41 patients at our center underwent surgery for aortic root abscess complicated by infective endocarditis of a mechanical prosthetic valve. Twenty (48.7%) met prespecified criteria for use of our valve-sparing technique after careful assessment of the mechanical valve and surrounding tissues. Our technique involved draining the abscess, aggressively débriding all infected and necrotic tissues, and then repairing the resulting defect by suturing a Gelweave patch to the healthy aortic wall and to the cuff of the valve. We successfully preserved the mechanical aortic valve in all 20 patients. Two (10%) died early (≤30 d postoperatively) of low cardiac output syndrome with progressive heart failure, superadded septicemia, and multisystem organ failure. At 1-year follow-up, the 18 surviving patients (90%) were symptom free and had a well-functioning mechanical aortic valve with no paravalvular leak. We conclude that, in certain patients, our technique for managing aortic root abscess and sparing the mechanical aortic valve is a safe and less time-consuming approach with relatively low mortality and encouraging midterm follow-up outcomes.


2020 ◽  
Vol 4 (5) ◽  
pp. 1-6
Author(s):  
Elyse Balzan ◽  
Alexander Borg

Abstract Background Infective endocarditis is a serious infection associated with high mortality and severe complications, such as heart failure, uncontrolled infection, and embolic events. Certain populations, including individuals with a prosthetic valve and those with native valve disease, such as bicuspid aortic valve, are considered to be more at risk of developing infective endocarditis. Case summary A 51-year-old previously healthy male presented with a 2-week history of persistent fever, malaise, and night sweats despite taking a long course of oral antibiotics. Examination was unremarkable; however, blood tests showed elevated inflammatory markers. Three sets of blood cultures revealed coagulase-negative gram-positive cocci (later identified as Staphylococcus lugdunensis), and the patient was subsequently started on IV antibiotics. His echocardiography showed a bicuspid aortic valve with severe regurgitation, and an aortic root abscess surrounding a dilated aortic root. In view of the presence of locally uncontrolled infection, the patient was referred for urgent debridement of the abscess and replacement of the aortic valve with tissue prosthesis. Fortunately, after a total of 6 weeks of IV antibiotics and successful operative management, our patient made a complete recovery. Discussion The development of an aortic root abscess occurs in 10–40% of cases of aortic valve endocarditis. Clinically, this should be suspected in any patient with endocarditis who fails to improve despite appropriate antibiotic therapy. This case demonstrates that severe infective endocarditis can develop in apparently healthy individuals due to underlying cardiac abnormalities.


2021 ◽  
pp. 201010582110194
Author(s):  
Raja Ezman Faridz Raja Shariff ◽  
Hafisyatul Aiza Zainal Abidin ◽  
Sazzli Kasim

Infective endocarditis (IE) commonly complicates bicuspid aortic valve. We report an uncommon case of bicuspid aortic valve (BAV) IE with aortic root abscess (ARA), presenting initially with abdominal pain due to splenic infarcts, delaying prompt diagnosis. A 38-year-old gentleman presented with fever and abdominal pain. He was treated for intra-abdominal sepsis, was started on intravenous antibiotics and had a computed tomography scan of the abdomen that revealed a large splenic infarct. The patient deteriorated, prompting further investigations, including echocardiography due to findings of a new murmur, signs of embolisation and blood cultures revealing Staphylococcus aureus. This revealed an otherwise unknown BAV with aortic valve vegetation and ARA. IE and ARA commonly affect patients with bicuspid aortic valve, and our case highlights the importance of systemic review, as IE often manifest clinically in various forms.


2011 ◽  
Vol 28 (8) ◽  
pp. E160-E163
Author(s):  
Erkan İlhan ◽  
Şennur Ünal Dayı ◽  
Erdinç Hatipsoylu ◽  
Emrah Bozbeyoğlu ◽  
Şebnem Albeyoğlu ◽  
...  

2008 ◽  
Vol 34 (3) ◽  
pp. 583-588 ◽  
Author(s):  
Feyzan Özaslan ◽  
Thomas Wittlinger ◽  
Nadejna Monsefi ◽  
Tamimount Bouhmidi ◽  
Sinthu Theres ◽  
...  

2018 ◽  
Vol 11 (5) ◽  
pp. 99
Author(s):  
G. I. Kim ◽  
D. V. Shmatov ◽  
M. S. Stolyarov ◽  
R. Yu. Kappushev ◽  
M. A. Novikov ◽  
...  

2016 ◽  
Vol 209 ◽  
pp. 275-277 ◽  
Author(s):  
Shuran Huang ◽  
Jing Ping Sun ◽  
Zhanguo Sun ◽  
Yueqin Chen ◽  
Lei Li ◽  
...  

Author(s):  
Mojyan Safari ◽  
Nadejda Monsefi ◽  
Afsaneh Karimian-Tabrizi ◽  
Aleksandra Miskovic ◽  
A Vanlinden ◽  
...  

Background The aim of this study was to evaluate the longer-term results of bicuspid aortic valve (BAV) repair with or without aortic root replacement. Methods From 1999 to 2017, 142 patients with or without aortic root dilatation who underwent repair of a regurgitant BAV were included in the study. Ninety-four patients underwent isolated BAV repair (Group 1; mean age 45±14 years) and 48 patients underwent valve-sparing aortic root replacement plus BAV repair (aortic valve reimplantation – Group 2; mean age 49±13 years. Median follow-up time was 5.9 years (range 0.5-15) in Group 1 and 3 years (range 0.5-16) in Group 2, respectively. Results In-hospital mortality was 1% in group 1, and 2% in Group 2 (p=0.6). The 5- and 10-year survival was 93±2.9% and 81±5.8% in Group 1 and 96±3.1% and 96±3.1% in Group 2, respectively (p=0.31). Eleven patients of Group 1 (1.7% /patient-year) and 5 patients of Group 2 (2.2%/patient-year) underwent reoperation of the aortic valve (p=0.5). The 5- and 10-year freedom from reoperation were 93.0±2.1% and 77.1±7.1% in Group 1 and 93.0±5.0% and 76.7±9.6% in Group 2 (p=0.83), respectively. At latest follow-up only 2 patients of Group 1 and 1 patient of Group 2 had AR=2° (p=0.7). The cumulative linearized incidence of all valve-related complications (bleeding, stroke, endocarditis, reoperation) was 2.9%/patient-year in Group 1 and 4%/patient-year in Group 2, respectively (p=0.6). Conclusions Isolated BAV repair and combined aortic valve reimplantation plus BAV repair provide good clinical longer-term outcomes with relatively low reoperation rate and durable valve function.


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