Eustachian valve endocarditis: a rare complication of automatic implantable cardioverter defibrillator placement

Eustachian valve (EV) endocarditis is extremely rare and often difficult to diagnose. An extensive review of the English literature has shown no report of EV endocarditis as a complication of the automatic implantable cardioverter defibrillator (AICD). A rare case is reported following AICD placement that was diagnosed by clinical findings of sepsis and positive blood cultures, and supported (using transesophageal echocardiography) by the presence of vegetations attached to the EV. Previously reported cases of EV endocarditis are reviewed, and its significance discussed in the setting of an increased use of AICD.