We report a case of a 58 year-old male with polysplenia and left inferior vena cava draining into the right atrium via hemiazygous vein; the left superior vena cava and the coronary sinus in order. He presented dyspnea on exertion and atrial fibrillation. Originally, through findings of mediastinal widening in chest X-ray and the double lumen of the descending aorta in transesophageal echocardiography, he was erroneously diagnosed with aortic dissection. The anomalous venous connection was discovered via spiral CT and venography. We also found three to five small spleens via CT. We emphasize that normal left superior vena cava mimic aortic dissection on chest X-rays and transesophageal echocardiographys.
Aorta, Thoracic ; Atrial Fibrillation ; Coronary Sinus ; Dyspnea ; Echocardiography, Transesophageal ; Heart Atria* ; Heterotaxy Syndrome* ; Humans ; Male ; Middle Aged ; Phlebography ; Spleen ; Thorax ; Tomography, Spiral Computed ; Veins ; Vena Cava, Inferior* ; Vena Cava, Superior*

About 50 cases of Listeria monocytogenes endocarditis were reported in worldwide literature in 1950-1995. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate is higher. However, there has not been a report in Korean literature. We report a case of 55 year-old male with rapidly progressive native aortic endocarditis caused by L. monocytogenes. He had neither history of underlying cardiac disease nor definitive predisposing factor. He presented mild dyspnes, chest pain and febrile sensation for a week. Echocardiography showed large vegetation in aortic valve and severe aortic regurgitation. L. monocytogenes grew on blood culture. We underwent artificial aortic valve replacement due to rapidly progessive heart failure. A thromboembolism occured at right femoral artery on postoperative 2nd day was removed successfully. He discharged without any sequellae.
Adult* ; Aortic Valve ; Aortic Valve Insufficiency ; Causality ; Chest Pain ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Femoral Artery ; Heart Diseases ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensation ; Thromboembolism