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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Emergency Double Valve Replacement for Ruptured Mitral Valve Aneurysm and Annular Abscess Caused by Gemella
Yoshihiko Onishi1, Takayuki Abe1, Yuki Hirai1
1Department of Cardiac Surgery, Saitama Cardiovascular and Respiratory Disease Center, Kumagaya, Saitama, Japan.
Introduction:
Mitral valve aneurysm (MVA) is a rare but potentially fatal complication of infective endocarditis (IE), often associated with aortic valve involvement. Gemella morbillorum, a commensal oral bacterium, is an uncommon cause of IE. We report a rare case of MVA rupture with an aortic annular abscess caused by G. morbillorum IE in a patient with bicuspid aortic valve (BAV), successfully managed with emergency valve replacement.
Case Presentation:
A 36-year-old man presented with congestive heart failure and respiratory failure. Echocardiography revealed a ruptured MVA, severe mitral and aortic regurgitation, and an annular abscess. The patient underwent emergency mitral and aortic valve replacement. Intraoperative findings included extensive destruction of the anterior mitral leaflet and a BAV. Blood cultures grew G. morbillorum. The patient recovered uneventfully following 6 weeks of targeted antibiotic therapy.
Conclusions:
Although IE caused by G. morbillorum is rare, it can lead to life-threatening complications such as MVA rupture and annular abscess. Early diagnosis and prompt surgical intervention are critical to achieving favorable outcomes.
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