Dataset Information

Infective endocarditis of an asymptomatic congenital aorta-right atrial tunnel: a case report.

ABSTRACT: Background:Aorta-right atrial tunnel (ARAT) is a rare congenital anomaly whose aetiology and incidence are unknown. It might represent a diagnostic and therapeutic challenge requiring a combination of imaging modalities and an integrated teamwork. Case summary:We report a case of a 23-year-old man with an asymptomatic ARAT complicated by infective endocarditis, diagnosed with non-invasive multimodality imaging, and successfully treated with a catheter-based approach. Discussion:Aorta-right atrial tunnel closure in asymptomatic patients is still a matter of debate. Considering the risk of serious complications surgical treatment might be recommended soon after diagnosis. In selected cases, catheter-based closure might represent a safe, effective, and less invasive alternative to traditional surgical approach.

SUBMITTER: Onorato EM

PROVIDER: S-EPMC7180523 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Infective endocarditis of an asymptomatic congenital aorta-right atrial tunnel: a case report.

Onorato Eustaquio Maria EM Costante Anna Maria AM Andreini Daniele D Bartorelli Antonio L AL

European heart journal. Case reports 20200221 2

<h4>Background</h4>Aorta-right atrial tunnel (ARAT) is a rare congenital anomaly whose aetiology and incidence are unknown. It might represent a diagnostic and therapeutic challenge requiring a combination of imaging modalities and an integrated teamwork.<h4>Case summary</h4>We report a case of a 23-year-old man with an asymptomatic ARAT complicated by infective endocarditis, diagnosed with non-invasive multimodality imaging, and successfully treated with a catheter-based approach.<h4>Discussion ...[more]

PMID: 32352048

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Project description:BackgroundInfective endocarditis has a relevant clinical impact due to its high morbidity and mortality rates. Right-sided endocarditis has lower complication rates than left-sided endocarditis. Common complications are multiple septic pulmonary embolisms, haemoptysis, and acute renal failure. Risk factors associated with right-sided infective endocarditis are commonly related to intravenous drug abuse, central venous catheters, or infections due to implantable cardiac devices. However, patients with congenital ventricular septal defects might be at high risk of endocarditis and haemodynamic complications.Case presentationIn the following, we present the case of a 23-year-old man without a previous intravenous drug history with tricuspid valve Staphylococcus aureus endocarditis complicated by acute renal failure and haemoptysis caused by multiple pulmonary emboli. In most cases, right-sided endocarditis is associated with several common risk factors, such as intravenous drug abuse, a central venous catheter, or infections due to implantable cardiac devices. In this case, we found a small perimembranous ventricular septal defect corresponding to a type 2 Gerbode defect. This finding raised the suspicion of a congenital ventricular septal defect complicated by a postendocarditis aneurysmal transformation.ConclusionsManagement of the complications of right-sided infective endocarditis requires a multidisciplinary approach. Echocardiographic approaches should include screening for ventricular septal defects in patients without common risk factors for tricuspid valve endocarditis. Patients with undiagnosed congenital ventricular septal defects are at high risk of infective endocarditis. Therefore, endocarditis prophylaxis after dental procedures and/or soft-tissue infections is highly recommended. An acquired ventricular septal defect is a very rare complication of infective endocarditis. Surgical management of small ventricular septal defects without haemodynamic significance is still controversial.

Dataset Information

Infective endocarditis of an asymptomatic congenital aorta-right atrial tunnel: a case report.

Publications

Infective endocarditis of an asymptomatic congenital aorta-right atrial tunnel: a case report.

Similar Datasets

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