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Rapidly Enlarging Aortic Root Pseudoaneurysm in a Child With Endocarditis and Repaired Congenital Heart Disease

Aakansha A Singh1, Ganesh K Gnanappa1, Yishay Orr1

  • 1Heart Centre for Children at the Children's Hospital at Westmead, Sydney, New South Wales, Australia.

JACC. Case Reports
|November 12, 2021
PubMed

Insights

A child with repaired double outlet right ventricle developed Staphylococcus aureus bacteremia. Close echocardiographic monitoring is crucial for detecting aortic pseudoaneurysms in repaired congenital heart defects during bacteremia.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Cardiovascular Surgery

Background:

  • Double outlet right ventricle (DORV) is a complex congenital heart defect.
  • Repaired DORV patients can be susceptible to infections like Staphylococcus aureus bacteremia.
  • Bacteremia poses risks for cardiovascular complications, including pseudoaneurysm formation.

Observation:

  • A pediatric patient with repaired DORV presented with Staphylococcus aureus bacteremia.
  • Initial echocardiography did not reveal aortic pseudoaneurysm despite clinical improvement on antibiotics.
  • A subsequent routine echocardiogram identified a critical aortic pseudoaneurysm.

Findings:

  • Staphylococcus aureus bacteremia can lead to the development of aortic pseudoaneurysms in patients with repaired congenital heart defects.
  • Aortic pseudoaneurysms may not be evident on initial echocardiography during bacteremia.
  • The patient required a Ross-Konno operation to address the aortic pseudoaneurysm.

Implications:

  • Close and repeated echocardiographic surveillance is essential for patients with repaired congenital heart defects experiencing bacteremia.
  • Early detection of aortic pseudoaneurysms through vigilant monitoring can prevent severe complications.
  • This case highlights the importance of a comprehensive approach to managing bacteremia in complex pediatric cardiac conditions.

Keywords:
double outlet right ventricleechocardiographyendocarditis

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