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Case report: pseudoaneurysm of left ventricle secondary to infective endocarditis complicated by cardiac rupture-a

Sara Ruggerini1, Andrea Venturelli1, Alberto Giovanni Tripodi2

  • 1Cardiology Unit, Ospedale 'Ceccarini', Riccione (Rimini), Azienda USL della Romagna, Viale Frosinone, 7, Riccione, RN 47838, Italy.

European Heart Journal. Case Reports
|July 15, 2024
PubMed
Abstract

Insights

Left ventricular pseudoaneurysm (LV PSA) is a rare, high-risk complication of infective endocarditis (IE). Prompt diagnosis and multimodality imaging are crucial for surgical planning and successful treatment of this potentially lethal condition.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Left ventricular pseudoaneurysm (LV PSA) is a rare but serious complication of infective endocarditis (IE).
  • Diagnosis can be challenging due to unclear incidence and pathogenesis.
  • LV PSA carries a high risk of fatal free wall rupture.

Observation:

  • A 69-year-old female with a history of IE and Staphylococcus aureus sepsis underwent mitral valve replacement.
  • Post-operatively, she developed persistent fever and valve detachment.
  • Transesophageal echocardiography (TOE) and CT scans revealed a LV PSA with severe mitral regurgitation.

Findings:

  • The patient underwent successful reoperation with a pericardial patch to exclude the PSA and implantation of a mechanical valve.
  • Follow-up TOE confirmed PSA exclusion with mild, hemodynamically insignificant mitral regurgitation.

Implications:

  • This case highlights LV PSA as a consequence of peri-annular IE extension.
  • Multimodality imaging (echocardiography and CT) is essential for accurate diagnosis and surgical planning.
  • Prompt treatment of LV PSA is critical due to its potentially lethal nature.
Keywords:
Case reportEndocarditisMultimodality imaging approachPseudoaneurysm

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