Images in cardiovascular disease: a rare case of perforated abscess of mitral valve after Infective Endocarditis (IE).
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ABSTRACT:
SUBMITTER: Niedzwiedzka A
PROVIDER: S-EPMC11375837 | biostudies-literature | 2024 Sep
REPOSITORIES: biostudies-literature
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Images in cardiovascular disease: a rare case of perforated abscess of mitral valve after Infective Endocarditis (IE).
Niedźwiedzka Agata A Pawlak Agnieszka A Suwalski Piotr P Gil Robert R
Journal of cardiovascular imaging 20240905 1
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Project description:IntroductionPerivalvular abscess in native valve infective endocarditis (IE) is associated with significantly increased mortality.Case descriptionHerein, we report a 29 year old Indian male who presented with culture negative IE with perivalvular abscess and severe mitral regurgitation requiring mitral valve replacement.DiscussionInitial approach is very difficult in terms of when IE presents as culture negative. This case highlights the important role of echocardiography in the management of culture negative IE.
| S-EPMC6426010 | biostudies-literature
Project description:Infective endocarditis (IE) is defined as infection of endocardial surface of the heart. It may include one or more heart valves, the mural endocardium or a septal defect. Its intracardiac effect includes severe valvular insufficiency which may lead to intractable congestive heart failure and myocardial abscess. Infective endocarditis especially complicated by an abscess is associated with high mortality, despite the medical and surgical therapeutic options available. Surgical intervention is indicated in cases of heart failure or uncontrolled infection and sometimes for the prevention of embolic phenomena. We report a case of 42 yrs/M with RVHD admitted in Dr D.Y.Patil hospital, Kolhapur. He had high grade, continuous fever, vomiting, cough with expectoration since 15 days prior to admission. He had prior embolic stroke 2 months back from which he recovered completely. The diagnosis of Infective endocarditis was confirmed clinically & echocardiographically by Duke's criteria. His ECHO showed severe MR, Moderate MS and large vegetations on AML oscillating through mitral orifice along with subvalval (mitral) abscess. Due to severe haematemesis following Mallory weiss tear surgical intervention was not possible. Patient succumbed as a result of refractory pulmonary oedema.
| S-EPMC5353443 | biostudies-literature
Project description: Not available
| S-EPMC6795564 | biostudies-literature
Project description: Not available
| S-EPMC10897740 | biostudies-literature
Project description:Mitral valve repair is the ideal approach in managing mitral valve infective endocarditis for patients requiring surgery. However, viable repair is influenced by the extent of valve destruction and there can be technical challenges in reconstruction following debridement. Overall, data describing long-term outcomes following mitral repair of infective endocarditis are scarce. We, therefore, assessed the late outcomes of 101 consecutive patients who underwent mitral valve repair for IE at the University of Ottawa Heart Institute from 2001 to 2021. The 5- and 10-year survival rate was 80.8 ± 4.7% and 61.2 ± 9.2%, respectively. Among these 101 patients, 7 ultimately required mitral valve reoperation at a median of 5 years after their initial operation. These patients were of a mean age of 35.9 ± 7.3 years (range 22-44 years) at the time of their initial operation. The 5- and 10-year freedom from mitral valve reoperation was 93.6 ± 3.4% and 87.7 ± 5.2%, respectively. Overall, mitral valve repair can be an effective method for treating infective endocarditis with a favourable freedom from reoperation and mortality over the long term.
| S-EPMC11434133 | biostudies-literature
Project description:Key clinical messageMitral valve aneurysm is a rare imaging finding most caused by infective endocarditis. The concurrent presence of an aortic valve aneurysm is unique and foretells a severe presentation that would require valve replacement during the same admission.AbstractA 42-year-old male patient presented with intermittent fever, night sweats, and weight loss for 2 months. TEE showed a rare finding of concurrent mitral and aortic valve aneurysms, and blood cultures grew streptococcus mutans. His infective endocarditis was successfully treated with antibiotics and placement of mechanical mitral and aortic valves.
| S-EPMC10293578 | biostudies-literature
Project description:Background: Mitral valve repair is preferred in patients undergoing surgical treatment for infective endocarditis (IE) of the native mitral valve, however, radical resection of infected tissue and patch-plasty might potentially lead to low or non-durable repair. We aimed to compare a limited-resection and non-patch technique with the classic radical-resection technique. Methods: Eligible candidates were patients with definitive IE of the native mitral valve undergoing surgery between January 2013 and December 2018. Patients were classified according to the surgical strategy into two groups: limited- versus radical-resection strategy. Propensity score matching was used. Endpoints were repair rate, all-cause mortality (30-day and 2-year), re-endocarditis and reoperation at q-year follow-up. Results: After propensity score matching, 90 patients were included. Follow-up was 100% complete. Mitral valve repair rate was 84% in the limited-resection versus 18% in the radical-resection strategy, p < 0.001. The 30-day and 2-year mortality were 20% versus 13% (p = 0.396) and 33% versus 27% (p = 0.490) in the limited-resection versus radical-resection strategy, respectively. The incidence of re-endocarditis during the 2-year follow-up was 4% in the limited-resection strategy versus 9% in the radical-resection strategy, p = 0.677. Three patients in the limited-resection strategy underwent reoperation of the mitral valve, while there were none in the radical-resection strategy (p = 0.242). Conclusions: Although mortality in patients with IE of the native mitral valve remains high, the limited-resection and non-patch surgical strategy is associated with a significantly higher repair rates with comparable 30-day and mid-term mortality, risk of re-endocarditis and re-operation compared to the radical-resection strategy.
| S-EPMC10144351 | biostudies-literature
Project description:BackgroundTranscatheter valve-in-valve replacement (TMViVR) is an alternative option for patients with bioprosthetic valve failure (BVF) who are at high surgical risk. Although infective endocarditis (IE) after transcatheter mitral valve-in-valve replacement is unusual, it is associated with significantly high mortality.Case presentationAn 81-year-old male patient was admitted with intermittent thoracic tightness, chest pain persisting for 3 years, and shortness of breath with nausea for 1 week. Two months prior, he received transcatheter mitral valve-in-valve replacement for recurrent heart failure and severe prosthetic mitral regurgitation. He developed a fever in the early postoperative period after TMViVR, with Staphylococcus lugdunensis bacteremia detected. He was discharged from the hospital after the blood culture turned negative following antibiotic treatment. During this hospitalization, prosthetic valve endocarditis was confirmed, resulting in severe prosthetic mitral stenosis and severe pulmonary hypertension. Blood cultures identified Staphylococcus lugdunensis again. Despite anti-infective therapy, the patient succumbed to complications from his complex medical history and comorbidities.ConclusionsWhile transcatheter valve implantation provides an alternative option for dealing with valvular disease, prosthetic valve endocarditis (PVE) as an unusual but catastrophic complication with poor prognosis should be taken seriously. Early detection through echocardiography, especially in high-risk patients presenting with suspicious symptoms, is crucial for timely intervention. Additionally, an appropriate perioperative antibiotic regimen is essential to prevent infection and improve prognosis.
| S-EPMC11770926 | biostudies-literature
Project description:BackgroundThe delayed development of a mitral valve annulus pseudoaneurysm is a rare and late complication of a native mitral abscess cavity.Case summaryCurrently, there are no documented cases of a pseudoaneurysm developing from an abscess cavity of the posterior annulus of the native mitral valve. We report a case of a patient who presented with worsening progressive shortness of breath that was found to be secondary to a pseudoaneurysm. This was detected by 2D echocardiogram and cardiac computed tomography angiography.DiscussionIn our case, the patient developed a late complication of a ventricular pseudoaneurysm originating from the mitral annular area of the abscess cavity. Per the surgical literature, one method to avoid the aforementioned complication is via cavity repair with a bovine patch.
| S-EPMC8837637 | biostudies-literature
Project description: Not available
| S-EPMC11041825 | biostudies-literature