Infective endocarditis leading to pulmonary pseudoaneurysm and severe pulmonary valve regurgitation: A case report

Pulmonary pseudoaneurysm resulting from infective endocarditis is a rare complication in patients with congenital heart disease who have undergone conduit placement.

In this article, we report a rare case of late-onset bacterial infective endocarditis complicated by a pseudoaneurysm and severe pulmonary valve regurgitation in a 16-year-old girl with double-outlet right ventricle, ventricular septal defect, and pulmonary stenosis, who had previously undergone a Rastelli procedure at age 15.

Based on the patient's medical history and transthoracic echocardiography examinations and cardiac computed tomography angiography, a definitive diagnosis of late-onset bacterial infective endocarditis complicated by a pseudoaneurysm and severe pulmonary valve regurgitation was established.

Given the patient's worsening clinical condition, surgery for ventricular septal defect closure, placement of a new right-ventricle-to-pulmonary-artery conduit with a Gore-tex conduit was conducted.

The surgical procedure was successful. The patient was extubated 3 hours postoperatively and received 6 weeks of antibiotic therapy postoperatively, during which no further episodes of fever occurred, and the inflammatory markers decreased to normal levels.

For bacterial infective endocarditis associated with pulmonary pseudoaneurysm and severe pulmonary valve regurgitation, early surgical intervention is essential to mitigate further cardiac dysfunction and improve clinical outcomes.