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A rare case of mycotic pseudoaneurysm in a patient post Rastelli procedure with infective endocarditis

Cherrie Chua1, Kristie Then1, Khairul Faizah Mohd Khalid1

  • 1Paediatric Congenital Heart Center, National Heart Institute, Kuala Lumpur, Malaysia.

Cardiology in the Young
|December 13, 2022
PubMed

Insights

Mycotic pseudoaneurysms are a rare complication of infective endocarditis in children with congenital heart disease (CHD) and conduit placement. This case highlights late-presenting bacterial endocarditis causing a pseudoaneurysm in a child with pulmonary atresia after a Rastelli procedure.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatric Surgery

Background:

  • Congenital heart disease (CHD) encompasses a range of conditions affecting heart structure present at birth.
  • Surgical interventions like the Rastelli procedure are used to correct complex CHDs, such as pulmonary atresia with ventricular septal defect.
  • Infective endocarditis (IE) is an infection of the heart's inner lining or valves, posing significant risks.

Observation:

  • A late presentation of bacterial infective endocarditis was observed.
  • The patient was an 8-year-old girl with a history of pulmonary atresia with ventricular septal defect.
  • The patient had previously undergone a Rastelli procedure at 3 years of age.

Findings:

  • The infective endocarditis led to the development of a mycotic pseudoaneurysm.
  • Mycotic pseudoaneurysms are uncommon but serious complications, particularly in patients with CHD and prosthetic material.
  • This case illustrates a rare instance of IE-induced pseudoaneurysm in a pediatric patient post-complex cardiac surgery.

Implications:

  • Early recognition and management of infective endocarditis are crucial in pediatric patients with CHD, especially those with prosthetic conduits.
  • This case underscores the importance of considering IE as a cause of pseudoaneurysm formation in this vulnerable population.
  • Further research into long-term surveillance strategies for IE complications in pediatric cardiac surgery patients may be warranted.
Keywords:
Mycotic pseudoaneurysmRastelli conduitinfective endocarditisrelapse infective endocarditis

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