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[Severity of aortic ring abscess complicated by cardiac conduction abnormalities]
P L Massoure1, E Kéreun, J M Chevalier
1Service de Cardiologie, Hôpital des Armées R-Picqué, Bordeaux, France. plmassoure@aol.com
Annales De Cardiologie Et D'Angeiologie
|July 5, 2005
Summary
Severe cardiac conduction abnormalities (CCA) are common in aortic ring abscessed endocarditis, increasing mortality risk. Early cardiac surgery and definitive pacing are recommended for better outcomes in these complex cases.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Cardiac abscesses, particularly those involving the aortic ring, can lead to severe complications.
- Cardiac conduction abnormalities (CCA) are a significant concern in patients with endocarditis.
Observation:
- This study analyzed six cases of aortic ring abscesses complicated by CCA between 1995 and 2001.
- Common findings included severe heart failure, cerebral embolization, and various forms of atrioventricular block (AVB).
- Streptococcus and Staphylococcus were the predominant pathogens.
Findings:
- Complete AVB was a frequent complication, either revealing endocarditis or complicating its course.
- Medical management had a high mortality rate, whereas surgical intervention with subsequent pacing showed improved survival.
- Trifascicular block indicated endocarditis recurrence.
Implications:
- Severe CCA are characteristic of aortic ring abscessed endocarditis and are linked to higher mortality.
- Prompt transfer to a cardiac surgery center is crucial for effective management.
- Early implantation of definitive cardiac pacing is safe and effective, without increased risk of lead infection.