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Aortic Non-coronary Cusp Perforation Following Methicillin-Sensitive Staphylococcus aureus (MSSA) Endocarditis

Rea Isaac1, Dhara Rana2, Aobo Li2

  • 1School of Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, USA.

Cureus
|June 27, 2025
PubMed

Insights

Isolated aortic valve noncoronary cusp perforation is a rare complication of bacterial endocarditis. This case highlights the need for ongoing cardiac monitoring after infection to detect delayed complications like severe aortic insufficiency.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Bacterial endocarditis can lead to serious cardiac complications.
  • Perforation of the aortic valve, particularly the noncoronary cusp (NCC), is a rare but significant sequela.

Observation:

  • A 62-year-old male, post-recovery from Methicillin-sensitive Staphylococcus aureus (MSSA) endocarditis, presented with worsening cardiac symptoms.
  • Despite completing antibiotic treatment, the patient developed severe aortic insufficiency.

Findings:

  • The cause of aortic insufficiency was identified as an isolated perforation of the aortic valve's noncoronary cusp (NCC).
  • This perforation occurred as a late-onset complication following the initial endocarditis episode.

Implications:

  • This case emphasizes the critical need for diligent long-term cardiac monitoring in patients with a history of endocarditis.
  • Vigilant follow-up is essential to identify and manage potentially severe, delayed complications such as aortic valve perforation and insufficiency.
Keywords:
aortic endocarditisaortic pseudoaneurysmaortic valvemssa endocarditisnon-coronary cusp of aortic valvepseudoaneurysm

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