Late aortic root pseudoaneurysm after pericardial patch reconstruction for bicuspid aortic valve endocarditis: a case...

Area of Science:

• Cardiology
• Infectious Diseases
• Cardiovascular Surgery

Background:

• A 70-year-old male with a bicuspid aortic valve presented with oxacillin-sensitive Staphylococcus aureus bacteremia.
• The infection complicated into infective endocarditis, aortic root abscess, and embolic stroke.

Purpose of the Study:

• To describe the management of a complex aortic root endocarditis case.
• To emphasize the long-term surveillance needed after aortic root reconstruction.

Main Methods:

• Initial surgical intervention included aortic valve replacement, aortic root reconstruction with a bovine pericardial patch, and mitral valve repair.
• Repeat sternotomy with aortic root replacement using a valved conduit and coronary artery reimplantation was performed for recurrent symptoms.

Main Results:

• The patient initially improved but developed recurrent symptoms three years later due to pseudoaneurysm formation from patch dehiscence.
• The repeat surgery for aortic root replacement was successful.

Conclusions:

• Aortic root endocarditis with abscess formation presents significant surgical challenges.
• Long-term surveillance is crucial to detect pseudoaneurysms after complex aortic root repairs.