scholarly journals The Gerbode defect: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Nicholas Sunderland ◽  
Ahmed El-Medany ◽  
Justin Temporal ◽  
Laura Pannell ◽  
Gemina Doolub ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Low Grade ◽  
Care Needs ◽  
Intravenous Antibiotics ◽  
Gerbode Defect

Abstract Background  The Gerbode defect is a rare abnormal communication between the left ventricle (LV) and right atrium (RA). The lesion is either congenital or acquired. Acquired defects are largely iatrogenic or infective in origin. We present two cases of acquired Gerbode defects with similar clinical presentations but very different outcomes. Case summaries Patient 1 A 64-year-old male presented with features of decompensated cardiac failure and a low-grade temperature. Dehiscence of a recently implanted bioprosthetic aortic valve and high-velocity LV to RA jet (Gerbode defect) was found on echocardiography. Blood cultures grew Staphylococcus warneri and the diagnosis of infective endocarditis was established. The patient was treated with intravenous antibiotics and the aortic valve and Gerbode defect were successfully surgically repaired. Patient 2 An 81-year-old male presented after being found on the floor at home. On admission, he was clinically septic with evidence of decompensated heart failure. No clear infective focus was initially found. Transthoracic echocardiography revealed severe left ventricular impairment, with a normal bioprosthetic aortic valve. He was treated with intravenous antibiotics, but later deteriorated with evidence of embolic phenomena. Repeat echocardiography revealed a complex infective aortic root lesion with bioprosthetic valve dehiscence and flow demonstrated from the LV to RA. Unfortunately, the patient succumbed to the infection and cardiac complications. Discussion  The Gerbode defect is a rare but important complication of infective endocarditis and valve surgery. Care needs to be taken to assess for Gerbode defect shunts on echocardiogram, especially in the context of previous cardiac surgery.

scholarly journals 696. Bartonella quintana Endocarditis, A Case Series

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S400-S400
Author(s):  
Thomas D Dieringer ◽  
Glen Huang ◽  
Paul R Allyn ◽  
Jeffrey Klausner
Keyword(s):  
Renal Failure ◽  
Infective Endocarditis ◽  
Los Angeles ◽  
Aortic Valve ◽  
Literature Review ◽  
Case Series ◽  
The United States ◽  
Aortic Insufficiency ◽  
Homeless Population ◽  
Bartonella Quintana

Abstract Background Homelessness has been a growing issue in the United States and worldwide. Bartonella quintana, the causative agent of “Trench fever”, is a well known illness among homeless populations in urban centers. While many cases of B. quintana are self limited, the disease can have advanced presentations including endocarditis. We present a short case series of three cases of B. quintana infective endocarditis (IE) in homeless individuals in Los Angeles and review the literature of cases of B. quintana IE in the homeless population. Methods Here we report three cases of B. quintana IE encountered in homeless individuals at the University of California, Los Angeles (UCLA) hospital system. A literature review was also conducted. PubMed was searched for published cases of human IE secondary to B. quintana in homeless individuals. Results All three patients were male with ages ranging from 39 to 57 years old with a history of homelessness and alcohol use. Presentations were subacute to chronic in nature consisting of constitutional symptoms as well as a range of symptoms corresponding with heart and renal failure. Each patient was found to have varying degrees of aortic insufficiency with either identified aortic valve vegetation or valvular thickening. Diagnosis was made with a combination of Bartonella serologies and whole genome sequencing PCR. All three patient’s courses were complicated by renal failure at varying points limiting the use of gentamicin for the full treatment course. Two patients ultimately underwent aortic valve replacement due to severe aortic insufficiency and completed therapy with doxycycline and rifampin. A single patient was discharged with plan to complete doxycycline and rifampin therapy however was lost to follow up. A literature review of 10 manuscripts describing 13 cases of B. quintana IE were identified. All the patients were male and the median age was 45. Six of the cases were in Europe and eight were in North America. All cases had left sided valve involvement (10 aortic, 6 mitral, 3 both valves). No cases of right sided IE were identified. Conclusion B. quintana IE should be considered in homeless patients with a clinical presentation concerning for IE. A combination of serology and PCR testing can be useful in diagnosis of this uncommon cause of infective endocarditis. Disclosures Jeffrey Klausner, MD, MPH, Nothing to disclose

scholarly journals P1088Match and mismatch between opening area and resistance in mild and moderate rheumatic mitral stenosisP1089When should cardiovascular magnetic resonance imaging be considered in patients with chronic aortic or mitral regurgitation?P1090Echocardiographic characteristics of aortic valve fenestration with aortic regurgitation for aortic valve repairP1091Aortic regurgitation assessment by 3D transesophageal echocardiography vena contracta area: usefulness and comparison with 2D methods.P1092Characterising cardiomyopathy in mitral regurgitation due to barlow disease: role of CMRP1093Compensatory peripheral increase in artero-venous o2 difference to severe functional mitral regurgitation in heart failureP1094Prognostic impact of concomitant atrioventricular valve regurgitation in patients undergoing transcatheter aortic valve implantationP1095Morphological characterization of vegetations by real-time three-dimensional transesophageal echocardiography in infective endocarditis: prognostic impactP1096Relation between causative pathogen and echocardiographic findings in patients with infective endocarditis: is there an association and is it clinically relevant?P1097Aortic and mitral valve infective endocarditis: different clinical and echocardiographic features and peculiar complication ratesP1098Vegetation size relevance and impact on prognosis in patients with infective endocarditisP1099Causes of death on the valvular heart disease surveillance list- a 5 year auditP1100Left ventricular non-compaction and idiopathic dilated cardiomyopathy: the significant diagnostic value of longitudinal strainP1101The role of echocardiography in the management of diuretics withdrawal in patients with chronic heart failure and severely reduced ejection fraction: a prospective cohort studyP1102Outcomes in paediatric new onset left ventricle dysfunction and dilatation: differences between post-myocarditis and DCMP1103De novo mitral regurgitation as a cause of heart failure exacerbation in hypertrophic cardiomyopathyP1104Correlation of conventional and new echocardiograhic parameters with sudden cardiac death risk score in patients with hypertrophic cardiomyopathyP1105Inverse correlation between myocardial fibrosis and left ventricular function in rheumatic mitral stenosis: a preliminary study with cardiac magnetic resonanceP1106Left ventricular diastolic dysfunction and cardiac sympathetic derangement in patients with Anderson-Fabry disease: a 2D speckle tracking echocardiography and cardiac 123I-MIBG studyP1107Left ventricular hypertrophy and mild cognitive impairment as markers for target organ damage in hypertensive patients with multiple risk factorsP1108Subclinical left ventricular dysfunction in asymptomatic type 1 diabetic childrenP1109Minimal differences shown by echocardiography and NT-proBNP level distinguishing cardiotoxic effect related to breast cancer therapy in patients with or without HER2 expression.P1110Speed of recovery of left ventricular function is not related to the prognosis of takotsubo cardiomyopathy - a portuguese multicenter studyP1111Myocardial dysfunction in Takotsubo cardiomyopathy - more than meets the eye?P1112Obstructive sleep apnea and echocardiographic parameters

2016 ◽  
Vol 17 (suppl 2) ◽  
pp. ii227-ii234
Author(s):  
I. El-Dosouky ◽  
CL. Polte ◽  
T. Okubo ◽  
A. Gonzalez Gomez ◽  
B. Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Left Ventricular Function ◽  
Transesophageal Echocardiography ◽  
Ventricular Function ◽  
Takotsubo Cardiomyopathy ◽  
Left Ventricular

scholarly journals Left Ventricular Outflow Pseudoaneurysm after Aortic Valve Replacement for Active Infective Endocarditis

2009 ◽  
Vol 38 (6) ◽  
pp. 394-397
Author(s):  
Tomoki Choh ◽  
Shinichi Suzuki ◽  
Tomoyuki Minami ◽  
Hideyuki Iwaki ◽  
Yukihisa Isomatsu ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Ventricular ◽  
Active Infective Endocarditis ◽  
Left Ventricular Outflow

scholarly journals Application of the Konno procedure for infective endocarditis in native bicuspid aortic valve with annular abscess extending into the interventricular septum

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Toshio Doi ◽  
Kanetsugu Nagao ◽  
Hayato Obi ◽  
Akihiko Higashida ◽  
Masaya Aoki ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Interventricular Septum ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Ventricular Outflow ◽  
Surgical Field ◽  
Annular Abscess ◽  
Complex Surgery ◽  
Septal Abscess

Abstract Annular abscess is a serious complication of infective endocarditis, which often requires complex surgery and has a very high post-operative mortality rate. The Konno procedure involves valve annuloplasty for a narrow aortic annulus or left ventricular outflow tract stenosis in children; it is also performed for various cardiac conditions in adults. Here, we report a case of the Konno procedure performed in a patient with aortic valve infective endocarditis, with an annular abscess extending into the interventricular septum (IVS). A 58-year-old man who presented to our hospital with fever was diagnosed with aortic valve infective endocarditis caused by Streptococcus saccharolyticus. On echocardiography, an annular abscess in the direction of the IVS was detected, and surgery was planned. The Konno procedure was performed to secure an adequate surgical field and to debride and reconstruct the cavity created by the interventricular septal abscess. The patient was discharged uneventfully 29 days after surgery.

scholarly journals A Change of Heart: Case Series of Peripartum Cardiomyopathy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Sean Martin ◽  
Daniel Short ◽  
Chih Mun Wong ◽  
Dina McLellan
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Significant Proportion ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Ventricular Systolic Dysfunction ◽  
Diagnostic Challenge

Peripartum cardiomyopathy (PPCM) is an uncommon disease of pregnancy, occurring in about 1 in 2000 live births, and is characterized by the development of heart failure, due to left ventricular systolic dysfunction. It is associated with high rates of maternal and neonatal mortality. Cardiac disease is the leading cause of maternal death in the UK: PPCM accounts for about 17% of these. Clinical findings of decompensated heart failure (HF) are often masked by the normal physiological changes seen in pregnancy making the diagnosis challenging. A high index of suspicion is essential—prompting referral for echocardiogram, which is crucial for diagnosis. Favourable prognosis is dependent on the early initiation of HF medications. Although full recovery occurs in around half of cases, left ventricular systolic dysfunction persists in a significant proportion of patients with PPCM and the risk of recurrence in subsequent pregnancies is high. The pathophysiology of PPCM is under intense research. We present four patients with PPCM and a review of the literature. Owing to the diagnostic challenge of PPCM and decompensated HF in pregnant mothers and its high mortality rate without treatment, prompt investigation and referral are key to improving maternal survival.

scholarly journals Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Brancheau ◽  
George Degheim ◽  
Christian Machado
Keyword(s):  
Aortic Valve ◽  
Treatment Guidelines ◽  
Stable Condition ◽  
Disease Process ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Mechanical Aortic Valve ◽  
Increased Risk ◽  
Pacemaker Placement

A 53-year-old gentleman with a history of a mechanical aortic valve presented to the emergency department complaining of a sudden right-sided abdominal pain. He was found to have atrioventricular dissociation on his initial electrocardiogram and his blood cultures grew Streptococcus viridans. The suspicion for endocarditis with periaortic abscess was high so a transthoracic echocardiogram was performed and showed a mass in the left ventricular outflow tract. For better visualization, a transesophageal echocardiogram was recommended and revealed a bileaflet mechanical aortic valve with perivalvular abscess and valvular vegetation as well as severe eccentric paravalvular aortic regurgitation. After sterilization, the patient underwent a successful surgery. Postoperatively, he remained in complete heart block and a permanent pacemaker placement was performed after complete sterilization. He tolerated the procedure well and was discharged home in a stable condition. Perivalvular abscess is one of the most common cardiac complications of infective endocarditis and is associated with an increased risk of mortality. It is imperative to have appropriate treatment guidelines established. However, because of the relative nature of the disease process and the acuity at which intervention needs to be done, a true assessment of the duration of antibiotic therapy prior to surgical intervention, timing of pacemaker placement, and the type of pacemaker is controversial.

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