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[Infectious endocarditis associated with multiple mycotic aneurysms; report of a case]

S Taguchi1, H Takakura, T Hachiya

  • 1Department of Cardiovascular Surgery, Saitama Prefectural Circulatory and Respiratory Center, Saitama, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 15, 2006
PubMed

Insights

This case study details the successful management of a patient with infectious endocarditis (IE) and multiple mycotic aneurysms. The treatment involved a multidisciplinary approach including embolization, surgery, and valve repair for a complex Enterococcus faecalis infection.

Area of Science:

  • Cardiology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Infectious endocarditis (IE) is a serious infection that can lead to severe complications.
  • Mycotic aneurysms are a rare but life-threatening complication of IE, often requiring complex management.
  • This case involves a 68-year-old male with IE of the mitral valve complicated by aneurysms in the middle cerebral artery (MCA) and superior mesenteric artery (SMA).

Observation:

  • The patient presented with IE and concurrent mycotic aneurysms in the MCA and SMA.
  • Initial management included coil embolization of the SMA aneurysm and surgical treatment of the MCA aneurysm.
  • Antibiotic therapy for Enterococcus faecalis infection was administered throughout the treatment period.

Findings:

  • Successful management of both MCA and SMA mycotic aneurysms was achieved through a combination of endovascular and surgical interventions.
  • Mitral valve repair was successfully performed after controlling the IE, utilizing a flip-over technique for leaflet defect closure.
  • The patient's IE was effectively controlled with targeted antibiotic therapy.

Implications:

  • This case highlights the importance of a tailored, multidisciplinary approach for managing IE with multiple mycotic aneurysms.
  • The successful valve repair demonstrates the feasibility of reconstructive surgery in complex IE cases.
  • Further research and consensus are needed on the optimal treatment strategies for IE-associated mycotic aneurysms.

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