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Cardiac Phlegmon: Infectious Endocarditis Causing Ventricular Wall Rupture

Felix Fleißner1,2, Igor Tudorache1, Matthias Christgen3

  • 1Department of Cardiac, Thoracic, Transplantation, and Vascular Surgery, Hannover Medical School, Hannover, Germany.

The Thoracic and Cardiovascular Surgeon Reports
|November 6, 2020
PubMed

Insights

Infectious endocarditis can lead to rare cardiac complications. This case highlights a myocardial phlegmon causing left ventricular rupture after aortic valve replacement, successfully treated with reoperation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Infectious endocarditis valvularis is a serious condition.
  • Ventricular wall rupture is a rare but often fatal complication.

Observation:

  • A 49-year-old female patient with aortic valve endocarditis underwent valve replacement.
  • Post-operatively, she experienced a sudden free left ventricular wall rupture.

Findings:

  • Histopathology revealed myocardial infarction due to septic thromboembolism.
  • This resulted in a phlegmon-like myocardial appearance.

Implications:

  • This case underscores the potential for myocardial phlegmon formation.
  • Septic coronary embolism can precipitate cardiac rupture in endocarditis patients.
  • Prompt surgical intervention is crucial for survival.

Keywords:
aneurysminfectionopen heart surgery

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