Cardiobacterium hominis and Cardiobacterium valvarum: Two Case Stories with Infective Episodes in Pacemaker Treated Patients

Introduction: Cardiobacterium hominis and Cardiobacterium valvarum are well known, though rare, etiologic agents of infective endocarditis. Cardiac devices are increasingly implanted. Case Reports: Two cases of infective episodes in pacemaker (PM) treated patients with respectively C. hominis and C. valvarum are presented. In one case blood-culture bottles yielded growth of C. hominis at two episodes with two years apart. At the second episode a vegetation was recognized at the PM lead and the PM device and lead was removed. In the C. valvarum case, echocardiography revealed a bicuspid aortic valve with severe regurgitation and a more than 1 cm sized vegetation. Conclusion: The cases illustrate the diversity in disease severity by Cardiobacterium species. Careful follow up has to be performed in order not to overlook a relatively silent relapsing infection.

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

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa452 ◽

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.

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Faculty Opinions recommendation of Infective endocarditis in patients with bicuspid aortic valve or mitral valve prolapse.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733467158.793550445 ◽

2018 ◽

Author(s):

Wilbert Aronow

Keyword(s):

Infective Endocarditis ◽

Mitral Valve ◽

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Mitral Valve Prolapse

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Active infective endocarditis of a bicuspid aortic valve causing left ventricular outflow tract pseudoaneurysm and right atrium shunt: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.106527 ◽

2021 ◽

pp. 106527

Author(s):

Tsubasa Mikami ◽

Daisuke Yoshioka ◽

Takuji Kawamura ◽

Koichi Toda ◽

Yoshiki Sawa ◽

...

Keyword(s):

Case Report ◽

Infective Endocarditis ◽

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Right Atrium ◽

Left Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Left Ventricular ◽

Active Infective Endocarditis ◽

Left Ventricular Outflow

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Fate of mild-to-moderate bicuspid aortic valve disease untreated during ascending aorta replacement

10.22541/au.160901985.50675267/v1 ◽

2020 ◽

Author(s):

Alessandro Verzini ◽

Marta Bargagna ◽

Guido Ascione ◽

Alessandra Sala ◽

Davide Carino ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Ascending Aorta ◽

Term Survival ◽

Kaplan Meier ◽

Aortic Root Surgery ◽

Increased Risk ◽

Aorta Replacement ◽

Ascending Aorta Replacement

Background: Bicuspid aortic valve (BAV) is the most common congenital heart defect and it is responsible for an increased risk of developing aortic valve and ascending aorta complications. In case of mild to moderate BAV disease in patients undergoing supracoronary ascending aorta replacement, it is unclear whether a concomitant aortic valve replacement should be performed. Methods: From June 2002 to January 2020, 75 patients with mild-to-moderate BAV regurgitation (± mild-to-moderate stenosis) who underwent isolated supracoronary ascending aorta replacement were retrospectively analyze. Clinical and echocardiographic follow-up was 100% complete (mean: 7.4±3.9 years, max 16.4). Kaplan Meier estimates were employed to analyze long-term survival. Cumulative incidence function for time to re-operation, recurrence of aortic regurgitation (AR)≥3+ and aortic stenosis (AS) greater than moderate, with death as competing risk, were computed. Results: There was no hospital mortality and no cardiac death occurred. Overall survival at 12 years was 97.4±2.5%, 95% CI [83.16-99.63]. At follow-up there were no cases of aortic root surgery whereas 3 patients underwent AV replacement. At 12 years the CIF of reoperation was 2.6±2.5%, 95% CI [0.20-11.53]. At follow up, AR 3+/4+ was present in 1 pt and AS greater than moderate in 3. At 12 years the CIF of AR>2+/4+ was 5.1±4.98% and of AS>moderate 6.9±3.8%. Conclusions: In our study mild to moderate regurgitation of a BAV did not significantly worse at least up to 10 years after isolated supracoronary ascending aorta replacement.

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Aortic diseases

ESC CardioMed ◽

10.1093/med/9780198784906.003.0689_update_001 ◽

2018 ◽

pp. 2861-2863

Author(s):

Bernard Iung

Keyword(s):

Aortic Valve ◽

Aortic Dissection ◽

Marfan Syndrome ◽

Bicuspid Aortic Valve ◽

Young Women ◽

Beta Blockers ◽

Aortic Aneurysms ◽

Maximum Diameter ◽

Aortic Diseases

Aortic diseases encountered in young women are mainly associated with syndromic diseases, which are often heritable, or bicuspid aortic valve. The most frequent syndromic disease is Marfan syndrome. In Marfan syndrome, the risk of aortic dissection is low during pregnancy when the maximum diameter of the ascending aorta is less than 45 mm. Dissection may affect the thoracic ascending or descending aorta. The risk of aortic dissection is low in bicuspid aortic valve when the aortic diameter is less than 50 mm. Beta blockers are recommended throughout pregnancy in Marfan syndrome and are often used in other causes of aortic aneurysms. Close echocardiographic follow-up is needed during pregnancy and after delivery.

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Aortic diseases

ESC CardioMed ◽

10.1093/med/9780198784906.003.0689 ◽

2018 ◽

pp. 2861-2863

Author(s):

Bernard Iung

Keyword(s):

Aortic Valve ◽

Aortic Dissection ◽

Marfan Syndrome ◽

Bicuspid Aortic Valve ◽

Young Women ◽

Beta Blockers ◽

Aortic Aneurysms ◽

Maximum Diameter ◽

Aortic Diseases

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Ten-year follow-up of unreplaced Valsalva sinuses after aortic valve replacement in bicuspid aortic valve disease

Archives of Cardiovascular Diseases ◽

10.1016/j.acvd.2018.11.014 ◽

2019 ◽

Vol 112 (5) ◽

pp. 305-313 ◽

Cited By ~ 1

Author(s):

Ramzi Abi Akar ◽

Noémie Tence ◽

Jérome Jouan ◽

Wassim Borik ◽

Philippe Menasché ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Bicuspid Aortic Valve ◽

Aortic Valve Disease ◽

Valve Disease

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Aortic valve-sparing root replacement in patients with bicuspid aortic valve: long-term outcome with the David I procedure over 20 years

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa083 ◽

2020 ◽

Vol 58 (1) ◽

pp. 86-93 ◽

Cited By ~ 3

Author(s):

Erik Beckmann ◽

Andreas Martens ◽

Heike Krüger ◽

Wilhelm Korte ◽

Tim Kaufeld ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Valves ◽

Term Outcome ◽

Long Term Outcome ◽

Initial Surgery ◽

Bicuspid Aortic Valves ◽

Valve Sparing

Abstract OBJECTIVES Aortic valve-sparing root replacement is an excellent treatment option for patients with intact tricuspid aortic valves. However, the durability in patients with bicuspid aortic valves is still a matter of debate. The aim of this study was to analyse the short- and long-term outcomes in patients with bicuspid aortic valves. METHODS Between July 1993 and October 2015, a total of 582 patients underwent the David I procedure, 50 of whom had a bicuspid aortic valve. In these patients, the mean age was 46 ± 13 years, and 80% (n = 40) were men. Follow-up was complete for 100% of patients and comprised a total of 552 patient-years with a mean follow-up time of 11 ± 5.2 years. RESULTS In addition to the David procedure, cusp plication was performed in 34% (n = 17) of patients and commissure repair in 8% (n = 4) of patients. There were no in-hospital deaths, and 1 patient (2%) had a perioperative stroke. The 1-, 5-, 10- and 20-year survival rates of patients after discharge were 98%, 94%, 88% and 84%, respectively. The rates for freedom from valve-related reoperation at 1, 5, 10 and 20 years after initial surgery were 98%, 88%, 79% and 74%, respectively. Long-term freedom from reoperation was comparable to that of patients with tricuspid aortic valves (P = 0.2). CONCLUSIONS The David procedure has excellent short-term results in patients with a bicuspid aortic valve. In this study, the long-term durability of reimplanted bicuspid aortic valves was comparable to that of tricuspid valves. However, careful patient selection might have contributed to this, and further studies might be needed to definitely clarify this issue.

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