Unusual Presentation of Aortic Valve Infective Endocarditis in a Dog: Aorto-Cavitary Fistula, Tricuspid Valve Endocarditis, and Third-Degree Atrioventricular Block

A 2-year-old Boxer with a history of subaortic stenosis and immunosuppressant therapy developed aortic valve infective endocarditis. On echocardiographic examination with simultaneous electrocardiographic tracing, multiple uncommon periannular complications of the aortic valve endocarditis were found, including aorto-cavitary fistula with diastolic left-to-right shunt, tricuspid valve endocarditis, and third-degree atrioventricular block. Necropsy confirmed the above echocardiographic findings. Although aortic valve endocarditis represents a well-known disease entity in dogs, the dynamic nature of this condition may allow development of complex and uncommon echocardiographic features.

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Pseudoaneurysm of the sinus of Valsalva caused by infective endocarditis in a 7-year-old child with congenital heart disease

Cardiology in the Young ◽

10.1017/s1047951121001128 ◽

2021 ◽

pp. 1-3

Author(s):

Wataru Kashimada ◽

Tao Fujioka ◽

Jotaro Kobayashi

Keyword(s):

Congenital Heart Disease ◽

Infective Endocarditis ◽

Aortic Valve ◽

Trisomy 21 ◽

Congenital Heart ◽

Septal Defect ◽

Subaortic Stenosis ◽

Sinus Of Valsalva ◽

History Of ◽

Patch Closure

Abstract We report a case of a pseudoaneurysm in the sinus of Valsalva, secondary to infective endocarditis in a child with trisomy 21. The patient had a history of subaortic stenosis, bicuspid aortic valve, and ventricular septal defect. Patch closure of the ostium of the pseudoaneurysm and aortic valve replacement was performed. The patient was discharged without severe complications.

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Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

The Heart Surgery Forum ◽

10.1532/hsf.1322 ◽

2015 ◽

Vol 18 (3) ◽

pp. 088

Author(s):

Ye-tao Li ◽

Xiao-bin Liu ◽

Tao Wang

Keyword(s):

Abdominal Pain ◽

Infective Endocarditis ◽

Aortic Valve ◽

Superior Mesenteric Artery ◽

Mesenteric Artery ◽

Mycotic Aneurysm ◽

Acute Abdominal Pain ◽

Rare Complication ◽

Emergency Operation ◽

History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

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Tricuspid valve infective endocarditis in a non-IVDU patient with atopic dermatitis

Oxford Medical Case Reports ◽

10.1093/omcr/omaa045 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Heerani Woodun ◽

Sarah Bouayyad ◽

Sura Sahib ◽

Nadir Elamin ◽

Steven Hunter ◽

...

Keyword(s):

Atopic Dermatitis ◽

Infective Endocarditis ◽

Tricuspid Valve ◽

Intravenous Drug User ◽

Blood Cultures ◽

Topical Steroids ◽

Foramen Ovale ◽

History Of ◽

The Right ◽

Systemic Infections

Abstract A 29-year-old male, with chronic atopic dermatitis (AD), presented with a 2-week history of fatigue, pyrexia and weight loss. Examination showed eczematous patches with lichenified papules, erosions on the right shin and a new murmur. Blood cultures isolated methicillin-sensitive Staphylococcus aureus. Transthoracic echocardiography showed vegetation on the tricuspid valve (TV) that was adherent to the septal leaflet. He was treated for infective endocarditis, attributed to poorly controlled AD, with intravenous Flucloxacillin. Due to ongoing sepsis and pulmonary septic emboli, Clindamycin was added. He underwent TV repair; the septal leaflet was excised, and the remnant two leaflets were brought together with a ring. His patent foramen ovale was closed. His skin was treated with topical steroids and emollients. Right-sided endocarditis of an intact TV is uncommon in a non-intravenous drug user. Therefore, this novel case portrays the importance of aggressively managing AD as it is a risk factor for significant systemic infections.

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Predictors of permanent pacemaker requirement after cardiac surgery for infective endocarditis

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872619848661 ◽

2019 ◽

pp. 204887261984866

Author(s):

Terence E Hill ◽

Erich L Kiehl ◽

Nabin K Shrestha ◽

Steven M Gordon ◽

Gosta B Pettersson ◽

...

Keyword(s):

Cardiac Surgery ◽

Infective Endocarditis ◽

Atrioventricular Block ◽

Tricuspid Valve ◽

Cleveland Clinic ◽

Permanent Pacemaker ◽

Infectious Endocarditis ◽

Conduction Abnormality ◽

Valvular Surgery ◽

Pacemaker Placement

Background:Infectious endocarditis is often complicated by conduction abnormalities at the time of presentation. Cardiac surgery is the treatment of choice for many infectious endocarditis patients, but carries an additional risk of persistent postoperative conduction abnormality. We sought to define the incidence and clinical predictors of significant postoperative conduction abnormalities necessitating permanent pacemaker implantation after cardiac surgery for infectious endocarditis.Methods:All consecutive patients with infectious endocarditis who were surgically treated at Cleveland Clinic from 2007 to 2013 were identified using the Cleveland Clinic Infective Endocarditis Registry and the Cardiovascular Information Registry. Patients with a pre-existing cardiac implantable electronic device were excluded. The primary outcome was the need for permanent pacemaker placement postoperatively for atrioventricular block. Regression analysis was performed to identify risk factors for permanent pacemaker requirement.Results:Among 444 infectious endocarditis patients who underwent cardiac surgery for infectious endocarditis, 57 (13%) required postoperative permanent pacemaker for atrioventricular block. Multivariable analysis identified that prolongation in preoperative PR and QRS intervals, Staphylococcus aureus as the infectious endocarditis organism, the presence of intracardiac abscess, tricuspid valve involvement, and prior valvular surgery independently predicted postoperative permanent pacemaker placement. The developed model exhibited excellent predictive ability (c-statistic 0.88) and calibration.Conclusion:Infectious endocarditis cardiac surgery patients often require a postoperative permanent pacemaker. Preoperative conduction abnormality, S. aureus infection, abscess, tricuspid valve involvement, and prior valvular surgery are strong predictors of postoperative permanent pacemaker placement.

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Tricuspid Valve Excision Complicated by Postoperative Gerbode Defect Following Recurrent Infective Endocarditis: A Case Report

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253220952260 ◽

2020 ◽

pp. 108925322095226

Author(s):

Jasdeep S. Dhaliwal ◽

Michael J. Wadle ◽

Rajasekhar Malyala ◽

Sanjay Dwarakanath ◽

Kevin W. Hatton

Keyword(s):

Infective Endocarditis ◽

Tricuspid Valve ◽

Surgical Intervention ◽

Critically Ill Patient ◽

Opioid Epidemic ◽

Intravenous Drug Use ◽

Recurrent Infections ◽

Number Of Patients ◽

Gerbode Defect ◽

Tricuspid Valve Endocarditis

Tricuspid valve infective endocarditis is an increasingly common sequela of the opioid epidemic. While often managed medically, certain subsets of patients will require surgical intervention, including repair, replacement, and possibly even excision. Historically, simple valvectomy was performed in instances of recidivism and reinfection; however, reoperation and replacement has become the preferred treatment in the current era. Given the increasing incidence of intravenous drug use and the increase in the number of patients presenting with recurrent infections, simple valvectomy has regained favor in recent years. In this article, we present the management of a critically ill patient with recurrent tricuspid valve endocarditis who underwent tricuspid valvectomy that was complicated by a left ventricle to right atrium fistula and discuss some of the most important perioperative issues and complications for patients who undergo tricuspid valvectomy.

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Reconstruction of a Previously Repaired Aortic Valve Destroyed by Infective Endocarditis: Case Report

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135116636571 ◽

2016 ◽

Vol 8 (3) ◽

pp. 408-410

Author(s):

Tomas Chalela ◽

Viktor Hraska

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Case Report ◽

Infective Endocarditis ◽

Aortic Valve ◽

Congenital Heart ◽

Congenital Aortic Stenosis ◽

Life Threatening ◽

History Of ◽

Uncommon Condition

Infective endocarditis (IE) is an uncommon condition among patients with congenital heart disease, however it can be life threatening. The usual management includes replacement of the affected valve, especially in patients with aortic valve compromise, and is even more common in previously repaired valves. In this case report, we describe the successful reconstruction of an aortic root destroyed by IE, in a patient with history of ballooning of a congenital aortic stenosis.

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Infective Endocarditis in a ?-thalassemia Major Child

Cardiovascular Journal ◽

10.3329/cardio.v7i2.22263 ◽

2015 ◽

Vol 7 (2) ◽

pp. 145-149

Author(s):

Sri Endah Rahayuningsih ◽

Rahmat Budi Kuswiyanto ◽

Herdiana Elizabeth Situmorang ◽

Evelyn Phangkawira

Keyword(s):

Infective Endocarditis ◽

Tricuspid Valve ◽

Heart Defects ◽

Good Condition ◽

Left Lung ◽

Thalassemia Major ◽

Sternal Border ◽

History Of ◽

Grade 3 ◽

Almost All

Almost all patients who develop infective endocarditis (IE) had history of congenital or acquired heart disease.We report a 9 years old boy who was diagnosed as ?-thalassemia major since age 1.5 years, admitted to hospital with chief complaint of difficulty of breathing for 1 week before admission, accompanied by fever. Holosystolic murmur of grade 3/6 was found in the lower left sternal border along with hepatosplenomegaly. Chest x-ray depicted right ventricle enlargement and opaque densities in the middle field of left lung. Blood culture showed growth of Staphylococcus aureus. Echocardiography detected thickening tricuspid valve with oscillating mass in the tricuspid valve, severe pulmonary hypertension, and minimal pericardial effusion. Diagnosis of IE was made. After clinical improvement he was discharged with good condition. The diagnosis of IE in children without heart defects is difficult to establish and right-sided IE is rare in children that a high suspicion index should be considered. DOI: http://dx.doi.org/10.3329/cardio.v7i2.22263 Cardiovasc. j. 2015; 7(2): 145-149

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Comparison of Valveplasty and Replacement for Surgical Treatment of Infective Tricuspid Valve Endocarditis

10.21203/rs.3.rs-842173/v1 ◽

2021 ◽

Author(s):

Xie Linfeng ◽

Chen Xiaodong ◽

He Jian ◽

Lin Sixian ◽

Chen Xingfeng ◽

...

Keyword(s):

Surgical Treatment ◽

Infective Endocarditis ◽

Tricuspid Valve ◽

Drug Users ◽

Clinical Effect ◽

Clinical Results ◽

Reoperation Rate ◽

Red Blood Cell Transfusion ◽

Significant Difference ◽

Tricuspid Valve Endocarditis

Abstract Background In recent years, due to the increase in intravenous drug injection and intracardiac and vascular interventional treatments among drug users, infective endocarditis involving the right heart of the tricuspid valve has gradually increased.At present, there is no systematic report on surgical treatment of tricuspid infective endocarditis. This paper summarizes the experience of surgical treatment of 56 patients with tricuspid infective endocarditis in our hospital and analyzes its clinical effect. Methods From January 2006 to August 2019, 56 cases of tricuspid infective endocarditis treated by tricuspid valve surgery in our hospital were analyzed retrospectively.including 23 cases of tricuspid valvuloplasty (TVP) and 33 cases of tricuspid valve replacement (TVR). All patients were complicated with tricuspid valve vegetations or moderate and severe tricuspid regurgitation and had surgical indications.The perioperative data were collected and followed up for 6 months to 14 years to summarize and analyze the clinical effect of surgical treatment of tricuspid infective endocarditis. Results Compared with TVR group, the CPB time (79.68 ± 19.02min VS 107.39 ± 25.64min, P < 0.01), ACC time (50.29 ± 16.14min VS 65.52 ± 20.62min, P < 0.01), postoperative mechanical ventilation time (18.65 ± 8.18h VS 44.85 ± 57.68h, P < 0.01) and ICU stay time (38.13 ± 21.80h VS 102.64 ± 142.11h, P = 0.015) in TVP group were shorter. The perioperative red blood cell transfusion (4.87 ± 3.81U VS 7.55 ± 5.42U, P < 0.01) and the incidence of postoperative complications (8.7% VS 33.3%, P < 0.01) were lower.Perioperative death occurred in 1 case in the TVR group, and there was no perioperative death in the TVP group, There was no significant difference between the two groups(3.03% VS 0, P = 0.855). A total of 52 cases were followed up for an average of (5.50 ± 3.79) years.The postoperative 3-year, 5-year and 7-year survival rate were 100%,100%,91.7% in TVP group and 95.2%, 93.8% and 87.5%.The 5-year and 10-year reoperation rate were 0%, 0% in TVP group and 6.7%, 20% in TVR group. Conclusion Surgical treatment of severe tricuspid valve endocarditis has achieved good mid-term clinical results, and the rate of avoiding reoperation is better in TVP group than in TVR group.

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