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Aspergillus cyst of aortic valve bioprosthesis

Ashraf M Anwar1, Youssef F M Nosir1, Mirvat Al-Asnaj1

  • 1Department of Cardiology, King Fahd Armed Forces Hospital, P.O. Box 9862, Jeddah, 21159, Kingdom of Saudi Arabia.

Journal of Echocardiography
|June 10, 2016
PubMed

Insights

Aspergillus endocarditis (AE) is a rare but serious complication after heart valve replacement. Despite treatment and surgery, the patient succumbed to the infection, highlighting the critical need for early diagnosis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Mycology

Background:

  • Aspergillus endocarditis (AE) is a rare and severe complication following cardiac surgery.
  • It carries a high mortality rate, underscoring the need for prompt recognition and management.

Purpose of the Study:

  • To report a case of Aspergillus endocarditis in a patient who underwent aortic and mitral valve replacement.
  • To emphasize the diagnostic challenges and clinical course of this rare condition.

Main Methods:

  • A 35-year-old female patient with a history of aortic and mitral valve replacement was evaluated.
  • Transesophageal echocardiography was performed to assess cardiac structures.
  • Surgical intervention and antifungal therapy were initiated.

Main Results:

  • Transesophageal echocardiography revealed an aortic root abscess and a cystic mass on the aortic bioprosthesis, containing fungal material.
  • The patient underwent bioprosthesis replacement and received amphotericin B treatment.
  • Despite aggressive management, the patient experienced sudden deterioration and died six weeks post-operatively.

Conclusions:

  • Aspergillus endocarditis poses a significant threat after valve replacement surgery.
  • Early diagnosis via transesophageal echocardiography and prolonged blood cultures is crucial for suspected AE cases.
  • Aggressive treatment including surgery and antifungal therapy may not always prevent fatal outcomes.
Keywords:
AbscessAortic valveAspergillosisEchocardiographyEndocarditisVegetation

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