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Perivalvular pseudoaneurysm caused by streptococcus dysgalactiae in the presence of prosthetic aortic valve

Daijiro Hori1, Kenichiro Noguchi, Yohei Nomura

  • 1Department of Cardiovascular Surgery, Fujigaoka Hospital, Showa University, Yokohama, Kanagawa, Japan. kansaku-ths@umin.ac.jp

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|July 14, 2012
PubMed

Insights

A perivalvular abscess in a patient with aortic valve replacement can progress to a life-threatening pseudoaneurysm. Frequent follow-up is crucial for early detection and intervention.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Innovation

Background:

  • A 62-year-old male with a history of aortic valve replacement presented with high-grade fever.
  • Blood cultures identified Streptococcus dysgalactiae, indicating a potential infection.

Observation:

  • Echocardiography revealed an edematous aortic annulus, suggestive of a perivalvular abscess.
  • Despite initial antibiotic treatment, a follow-up echocardiogram showed abscess progression and the formation of a rapidly enlarging pseudoaneurysm.

Findings:

  • The patient developed a 20-mm pseudoaneurysm originating from the aortic root's coronary cusps.
  • Surgical resection of the pseudoaneurysm and aortic root replacement were successfully performed after complete removal of infective tissue.

Implications:

  • This case underscores the critical need for vigilant monitoring of perivalvular abscesses post-aortic valve replacement.
  • Early detection and intervention for pseudoaneurysm formation are vital to prevent potentially fatal outcomes.

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