Active infective endocarditis of a bicuspid aortic valve causing left ventricular outflow tract pseudoaneurysm and right atrium shunt: A case report. (November 2021)

• Record Type: Journal Article
• Authors: Mikami, Tsubasa; Yoshioka, Daisuke; Kawamura, Takuji; Toda, Koichi; Sawa, Yoshiki; Miyagawa, Shigeru
• Is Part Of: International journal of surgery case reports. Volume 88(2021)
• Publication Date: 2021-11
• Subjects: LVOT Left ventricular outflow tract -- MAIVF Mitral-aortic intervalvular fibrosa; Left ventricular outflow tract pseudoaneurysm -- Infective endocarditis -- Bicuspid aortic valve -- Case report; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2021.106527
• Languages: English
• ISSNs: 2210-2612

Abstract

Abstract: Introduction and importance: Left ventricular outflow tract pseudoaneurysm associated with infective endocarditis is a rare but life-threatening condition. Case presentation: A 68-year-old man developed infective endocarditis of a bicuspid aortic valve with suspected annulus abscess and was transferred to our department for further treatment. Cardiac workup revealed the formation of a left ventricular outflow tract pseudoaneurysm penetrating the right atrium. We successfully treated the patient with pseudoaneurysm repair using a bovine pericardium patch in combination with aortic valve replacement. The patient was uneventfully discharged after 6-week antibiotic therapy and remained well for the following 2 years. Clinical discussion: Surgery is the recommended treatment for left ventricular outflow tract pseudoaneurysms. Accurate diagnosis and identification of the anatomical conditions are crucial for determining the appropriate treatment. Conclusion: When considering the appropriate surgical treatment for left ventricular outflow tract pseudoaneurysm associated with infective endocarditis, pseudoaneurysm repair using a bovine pericardial patch and concomitant aortic valve replacement can be an effective and feasible therapeutic option. Highlights: Infective endocarditis can cause left ventricular outflow tract pseudoaneurysms. Surgery is recommended for left ventricular outflow tract pseudoaneurysms. Accurate anatomical diagnosis is crucial for determining the appropriate treatment.