A Pediatric Case of Infective Endocarditis with Pseudoaneurysm of the Sinus of Valsalva and Annular Abscess
10.4326/jjcvs.43.260
- VernacularTitle:バルサルバ洞仮性動脈瘤と大動脈弁輪部膿瘍を呈した活動期感染性心内膜炎の1小児例
- Author:
Tomohito Kanzaki
;
Masaaki Koide
;
Yoshifumi Kunii
;
Kazumasa Watanabe
;
Takuya Maeda
;
Yuko Ohashi
- Publication Type:Journal Article
- Keywords:
infective endocarditis;
pseudoaneurysm of sinus of Valsava;
annular absess;
infant;
bicuspid aortic valve
- From:Japanese Journal of Cardiovascular Surgery
2014;43(5):260-264
- CountryJapan
- Language:Japanese
-
Abstract:
Although aortic annular abscess and rupture of the sinus of Valsalva are known as complications of infective endocarditis, few cases in children have been reported. We report a surgical case of a 6-year-old girl with active infective endocarditis complicated with an annular abscess and pseudoaneurysm of the sinus of Valsalva. The patient presented progressive symptoms of heart failure and a subsequent echocardiogram demonstrated severe aortic regurgitation. A computed tomography indicated pseudoaneurysm of sinus of Valsalva and an emergency operation was performed. At operation, a bicuspid aortic valve with vegetation was noted. The annular abscess caused a large tissue defect of the left coronary sinus of Valsalva and formed a pseudoaneurysm. The infected lesion was resected completely. The defective aortic annulus and sinus of Valsalva were repaired with a bovine pericardial patch and aortic valve was replaced with a mechanical valve. The postoperative course was uneventful and the patient was discharged after adequate antibiotic treatment.
