scholarly journals Bicuspid aortic valve infective endocarditis and aortic root abscess presenting initially as splenic infarctions

2021 ◽  
pp. 201010582110194
Author(s):  
Raja Ezman Faridz Raja Shariff ◽  
Hafisyatul Aiza Zainal Abidin ◽  
Sazzli Kasim
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Abdominal Sepsis ◽  
Systemic Review ◽  
Intravenous Antibiotics ◽  
Aortic Root Abscess ◽  
Uncommon Case

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.

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

2020 ◽  
Author(s):  
Despina Toader ◽  
Mioara Cocora ◽  
Constantin Bătăiosu ◽  
Luminiă Ocroteală
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Young Female ◽  
High Rate ◽  
Ventricular Septum ◽  
Ventricular Septum Defect ◽  
Aortic Root Abscess

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.

scholarly journals An aortic root abscess in a patient with a bicuspid aortic valve: a case report

2020 ◽  
Vol 4 (5) ◽  
pp. 1-6
Author(s):  
Elyse Balzan ◽  
Alexander Borg
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Complete Recovery ◽  
Operative Management ◽  
Native Valve ◽  
Night Sweats ◽  
Aortic Root Abscess ◽  
Long Course

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.

Aortic Root Abscess Complicated by Fistulization in a Young Patient with Bicuspid Aortic Valve

2011 ◽  
Vol 28 (8) ◽  
pp. E160-E163
Author(s):  
Erkan İlhan ◽  
Şennur Ünal Dayı ◽  
Erdinç Hatipsoylu ◽  
Emrah Bozbeyoğlu ◽  
Şebnem Albeyoğlu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Young Patient ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Aortic Root Abscess

Surgical treatment of infective endocarditis of the aortic valve complicated by aortic root abscess and false aneurysm

2018 ◽  
Vol 11 (5) ◽  
pp. 99
Author(s):  
G. I. Kim ◽  
D. V. Shmatov ◽  
M. S. Stolyarov ◽  
R. Yu. Kappushev ◽  
M. A. Novikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Aortic Root ◽  
False Aneurysm ◽  
Aortic Root Abscess

Bicuspid aortic valve complicated by pseudo-aneurysm of aortic root abscess

2016 ◽  
Vol 209 ◽  
pp. 275-277 ◽  
Author(s):  
Shuran Huang ◽  
Jing Ping Sun ◽  
Zhanguo Sun ◽  
Yueqin Chen ◽  
Lei Li ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Root ◽  
Aortic Root Abscess ◽  
Pseudo Aneurysm

scholarly journals Prevalence and predictors of aortic root abscess among patients with left-sided infective endocarditis: a cross-sectional comparative study

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Kareem Mahmoud ◽  
Tarek Hammouda ◽  
Hossam Kandil ◽  
Marwa Mashaal
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Root ◽  
Demographic Data ◽  
Paravalvular Leak ◽  
Imaging Data ◽  
Mechanical Prosthesis ◽  
Paravalvular Leakage ◽  
Aortic Root Abscess

Abstract Background Aortic root abscess (ARA) is a major complication of infective endocarditis that is associated with increased morbidity and mortality. Limited data are present about patient characteristics and outcomes in this lethal disease. We aimed to study the clinical and echocardiographic characteristics of patients with ARA compared to patients with left-sided infective endocarditis without ARA. We included patients with a definite diagnosis of left-sided infective endocarditis according to modified Duke’s criteria. The patients were classified into two groups according to the presence of ARA (ARA and NO-ARA groups). All the patients were studied regarding their demographic data, clinical characteristics, laboratory and imaging data, and complications. Results We included 285 patients with left-sided infective endocarditis. The incidence of ARA was 21.4% (61 patients). Underlying heart disease, mechanical prosthesis, bicuspid aortic valve, and prior IE were significantly higher in ARA. The level of CRP was higher in ARA (p = 0.03). ARA group showed more aortic valve vegetations (73.8% vs. 37.1%, p < 0.001), more aortic paravalvular leakage (26.7% vs. 4.5%, p < 0.001), and less mitral valve vegetations (21.3% vs. 68.8%, p < 0.001). Logistic regression analysis showed that the odds of ARA increased in the following conditions: aortic paravalvular leak (OR 3.9, 95% CI 1.2–13, p = 0.03), mechanical prosthesis (OR 3.6, 95% CI 1.5–8.7, p = 0.005), aortic valve vegetations (OR 3.0, 95% CI 1.2–8.0, p = 0.02), and undetected organism (OR 2.3, 95% CI 1.1–4.6, p = 0.02), while the odds of ARA decreased with mitral valve vegetations (OR 0.2, 95% CI 0.08–0.5, p = 0.001). We did not find a difference between both groups regarding the incidence of major complications, including in-hospital mortality. Conclusion In our study, ARA occurred in one fifth of patients with left-sided IE. Patients with mechanical prosthesis, aortic paravalvular leakage, aortic vegetations, and undetected organisms had higher odds of ARA, while patients with mitral vegetations had lower odds of ARA.

scholarly journals Two aortic root pseudoaneurysms in infective endocarditis in a patient with bicuspid aortic valve

2021 ◽  
Vol 10 (2) ◽  
pp. 62
Author(s):  
MohammadEsmaeil Zanganehfar ◽  
SeyedEhsan Parhizgar ◽  
Reza Kiani ◽  
HamidReza Pouraliakbar ◽  
Raheleh Kaviani ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Aortic Root

scholarly journals Mechanical Prosthetic Valve Sparing for Aortic Root Abscess Complicated by Infective Endocarditis

2020 ◽  
Vol 47 (4) ◽  
pp. 280-283
Author(s):  
Ahmed Ahmed ◽  
Ayman Ammar ◽  
Yasser Elnahas ◽  
Mohammed Abd Al Jawad
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Aortic Root ◽  
Prosthetic Valve ◽  
Paravalvular Leak ◽  
Mechanical Aortic Valve ◽  
Aortic Root Abscess ◽  
Mechanical Prosthetic Valve ◽  
Valve Sparing

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.

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