Endocarditis on the bicuspid aortic valve: what's the risk?

Baig, Wazir

doi:10.1136/hrt.2010.205633

Cited by 3 publications

(3 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While BAV can occur in isolation, it is frequently associated with other congenital cardiovascular malformations, such as coarctation of the aorta, interruption of the aorta, ventricular septal defect, atrial septal defect, patent ductus arteriosus and hypoplastic left heart syndrome, leading to a wide spectrum of clinical presentations ranging from severe disorder detected in utero to asymptomatic condition in old age (7). Patients with BAV are at high risk for the development of severe complications, including aortic valve regurgitation, aortic valvular stenosis, aortic dilation or even aneurysm, aortic dissection, thrombus formation, and infective endocarditis (8)(9)(10)(11). BAV accounts for 70-85% of aortic stenosis in pediatric patients and at least 50% of stenotic aortic valve in adults (12,13).…”

Section: Introductionmentioning

confidence: 99%

GATA5 loss-of-function mutations associated with congenital bicuspid aortic valve

Lin-mei

Tao

Qiu

et al. 2014

International Journal of Molecular Medicine

View full text Add to dashboard Cite

Bicuspid aortic valve (BAV) is the most common form of congenital cardiovascular defect in humans worldwide and is responsible for substantial morbidity and mortality. Accumulating evidence has demonstated that genetic risk factors are involved in the pathogenesis of BAV. However, BAV is genetically heterogeneous and the genetic basis underlying BAV in a large number of patients remains unknown. In the present study, the coding regions and splice junction sites of the GATA5 gene, which codes for a zinc-finger transcription factor crucial for the normal development of the aortic valve, was sequenced initially in 110 unrelated patients with BAV. The available relatives of the mutation carriers and 200 unrelated healthy individuals used as controls were subsequently genotyped for GATA5. The functional effect of the mutations was characterized by using a luciferase reporter assay system. As a result, two novel heterozygous GATA5 mutations, p.Y16D and p.T252P, were identified in two families with autosomal dominant inheritance of BAV, respectively. The variations were absent in 400 control chromosomes and the altered amino acids were completely conserved evolutionarily. Functional assays revealed that the two GATA5 mutants were associated with significantly reduced transcriptional activity compared with their wild-type counterpart. To the best of our knowledge, this is the first study on the association of GATA5 loss-of-function mutations with enhanced susceptibility to BAV, providing novel insight into the molecular mechanism involved in human BAV and suggesting a potential role for the early prophylaxis and personalized treatment of this common congenital heart disease.

show abstract

Section: Introductionmentioning

confidence: 99%

GATA5 loss-of-function mutations associated with congenital bicuspid aortic valve

Lin-mei

Tao

Qiu

et al. 2014

International Journal of Molecular Medicine

View full text Add to dashboard Cite

show abstract

“…Most of these are pediatric cases, and complications are limited to pericarditis or myocarditis, 3) but in some extreme cases, the infection may progress to endocarditis. 1,2) The exact mechanism by which varicella causes secondary bacterial endocarditis remains unclear; superinfection of skin pustules with a more toxic strain of S. aureus, and spread of infection to the vulnerable congenital bicuspid aortic valve could be a possible mechanism 4) and can be the cause of the worsening of the condition in our patient.…”

Section: Discussionmentioning

confidence: 91%

Adult Bicuspid Aortic Valve Endocarditis with Extensive Paravalvular Invasion Attributable to Disseminated Varicella Zoster Infection

Chen

Tsai

Chou

2012

ATCS

View full text Add to dashboard Cite

We report a previously healthy 21-year-old man who developed disseminated varicella zoster infection complicated with encephalitis, acute renal insufficiency, liver dysfunction, and an apparent pustular skin superinfection with Staphylococcus aureus. He later developed an extensively destructive endocarditis affecting a congenital bicuspid aortic valve, accompanied with leaflet perforation, complete atrio-ventricular (AV) block, and invasion of vegetation to both left and right atrium; the endocarditis was attributed to the same skin pathogen, S. aureus. He underwent radical debridement of the aortic valve, membranous ventricular septum, and mitral anterior fibrous trigone, followed by reconstruction of intracardiac defects with 2 autologous pericardial patches and aortic valve replacement. After a permanent pacemaker implantation and 4 weeks of antibiotic treatment, he was discharged after an uneventful postoperative course.

show abstract

“…6,7 Along with their increased risk for infection, they also appear to have increased rates of periannular complications such as abscess formation, pseudoaneurysm, and aorto-cavitary fistula. 6,8 It is conceivable that these patients could also be at higher risk for Gerbode defects as well. These patients should therefore have thorough intraoperative TEE exams to examine all the cardiac valves for signs of endocarditis and to evaluate for these aforementioned complications regardless of preoperative TTE findings.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Transesophageal Echocardiographic Detection of a Gerbode Defect in a Patient Referred for Aortic Valve Endocarditis: A Case Report

Fernando

Johnson

Richardson

2022

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

This clinical challenge discusses a case in which a patient was referred for aortic valve repair or replacement due to severe aortic regurgitation from infective endocarditis. In addition to discovering a previously unknown tricuspid valve vegetation, the intraoperative echocardiographic evaluation was instrumental in revealing an undiagnosed Gerbode defect. The flow through this Gerbode defect was previously mistaken for tricuspid regurgitation, and the patient was misdiagnosed as exhibiting severe pulmonary hypertension. This case highlights the importance of reviewing preoperative echocardiographic imaging, as well as diligence in completing a thorough intraoperative transesophageal echocardiographic exam prior to cardiopulmonary bypass. In addition, while flow typically occurs in Gerbode defects during systole, this case demonstrates that flow can also occur during diastole, which was most likely due to the severe aortic regurgitation. Fortunately, the patient was able to undergo successful treatment for the unexpected sequalae of the infective endocarditis, including repair of the Gerbode defect, tricuspid valve repair, and aortic valve and root replacement. Importantly, the incorrect diagnosis of severe pulmonary hypertension was removed.

show abstract

Endocarditis on the bicuspid aortic valve: what's the risk?

Cited by 3 publications

References 8 publications

GATA5 loss-of-function mutations associated with congenital bicuspid aortic valve

GATA5 loss-of-function mutations associated with congenital bicuspid aortic valve

Adult Bicuspid Aortic Valve Endocarditis with Extensive Paravalvular Invasion Attributable to Disseminated Varicella Zoster Infection

Intraoperative Transesophageal Echocardiographic Detection of a Gerbode Defect in a Patient Referred for Aortic Valve Endocarditis: A Case Report

Contact Info

Product

Resources

About