Aortic valve aneurysm associated with infective endocarditis: case report and review of literature

Abstract

Although there are several mitral valve aneurysm reports, studies on aortic valve aneurysm are extremely rare. This paper describes an uncommon case of a large saccular aortic valve aneurysm associated with infective endocarditis. A 37-year-old man was hospitalized in our hospital with fever and dyspnea. Echocardiography found severe aortic regurgitation and aortic valve aneurysm of the non-coronary cusp going in and out of the left ventricular chamber. Blood cultures grew Streptococcus viridance. Therefore, the patient underwent aortic valve replacement. During the operation, we observed a 30 × 20 mm ruptured aneurysm that arose from the non-coronary cusp. The aortic valve containing the aneurysm was resected and replaced with a mechanical heart valve. Histopathological examination of the aortic valve aneurysm showed active inflammatory changes. Infective endocarditis was considered to be the cause of this aortic valve aneurysm.

Perforated cuspal aneurysm of aortic valve following infective endocarditis presenting as complete heart block: a case report and review of literature

“…Treatment is often surgical with replacement of the diseased valve along with appropriate antibiotic therapy for management of infective endocarditis. 5 Histopathological evaluation of the diseased valve often reveals active inflammatory changes, myxoid degeneration as was seen in our case. 5 In patients with conduction block and infective endocarditis, the exact timing of PPI remains controversial in the absence of definite guidelines.…”

“…Most of the previously reported cases of aortic cuspal aneurysm and perforation present with acute heart failure. 5 The trigger for acute progressive congestive heart failure is the incarceration and rupture of the AV aneurysm into the LVOT which explains the haemodynamic deteriorations in our case. The CHB as a presentation of aortic cuspal aneurysm is very rare with just one case reported previously in the literature.…”

“…A review of literature revealed only 25 cases of aortic cuspal aneurysms till date of which perforation was reported in 12 (48%; Table 1 ). 5 , 6 , 8–17 Most of these cases were males (83.3%) with an average age of 50.9 years (range: 26–73 years). Infective endocarditis was confirmed or strongly suspected in 11/12 (91.7%) with right coronary cusp being most commonly involved.…”

“…This aneurysmal structure disappears or shrinks during systole and appears as a ring-like structure on short axis. 5 Jets of aortic regurgitation are appreciated on colour Doppler echocardiogram. Treatment is often surgical with replacement of the diseased valve along with appropriate antibiotic therapy for management of infective endocarditis.…”

Aortic valve cusp aneurysm as a result of blood culture‐negative infective endocarditis, interesting echocardiographic and surgical images

“…Infective endocarditis was the responsible cause in 16 patients (89%). In most cases, low virulent bacteria was the etiology and similar to our case there was no past history of underlying cardiovascular disease.…”