Healed perivalvular abscess: Incidental finding on transthoracic echocardiography

Datt, Vishnu; Diwakar, Anitha; Malik, Indra; Geelani, Muhammad Abid; Tomar, Akanksha; Virmani, Sanjula

doi:10.4103/0971-9784.129862

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…This condition is caused by the drainage and cavitation into the aorta [ 5 ]. The formation of periaortic abscess is a dynamic process [ 6 ] that can lead to the formation of a pseudoaneurysm or a vasculature. It can start with the aortic wall being thickened [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Occult deterioration of an aortic annular abscess: how do we diagnose a pseudoaneurysm periaortic valve? A case report

Chen,

Li,

Qiao

et al. 2023

BMC Cardiovasc Disord

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Background Infectious endocarditis (IE) is a disease caused by the colonization of toxic microorganisms on the endocardium of heart valves [1]. Although much progress has been made in the diagnosis and treatment of IE, its complications, such as annular abscesses [2], still have a high mortality rate. In this case, we describe a patient with infective endocarditis complicated by occult deteriorated aortic annular abscess. Case presentation A 44-year-old man was admitted due to weakness of his right limbs and unclear speech for 10 h. He had recurrent fevers for 1 month before admission. Transthoracic echocardiography showed a mix-echoic vegetation attached to the bicuspid aortic valve, moderate aortic regurgitation and a possible aortic annular abscess. Blood cultures were negative and empiric antibiotic therapy was begun. The patient did not have fever again and seem to be clinically improved. However, follow-up transesophageal echocardiography revealed a large periaortic abscess led to aortic sinus pseudoaneurysm. The patient underwent mechanical prosthetic valve replacement and annulus reconstruction successfully. Perivalvular abscess may be insidious deterioration in patients who seem to be clinically improved, which requires us to pay more attention. Discussion Occult deterioration of an aortic annular abscess is rare and more attention should be paid. Re-evaluation of echocardiography is required even if the patient’s symptoms improve.

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Section: Discussionmentioning

confidence: 99%

Occult deterioration of an aortic annular abscess: how do we diagnose a pseudoaneurysm periaortic valve? A case report

Chen,

Li,

Qiao

et al. 2023

BMC Cardiovasc Disord

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“…In the healed stage, echocardiography typically shows a zone of reduced echo-density without any color flow, makes the diagnosis easy. [ 11 ] Exact morphologic evaluation including volume and extent of the abscess, and relation with the coronary arteries is mandatory to plan the management of disease. The complications of myocardial abscess, like pseudoaneurysm and fistulization, may also be diagnosed by TEE.…”

Section: Discussionmentioning

confidence: 99%

Isolated myocardial abscess cavity

Garg

Bhargava

Garg

et al. 2021

Annals of Cardiac Anaesthesia

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Myocardial abscess is a suppurative infection of myocardium, endocardium, native or prosthetic valves, perivalvular structures and cardiac conduction system. It develops in about 20% of patients with infective endocarditis. Due to avascular and fibrous structures, valvular regions are commonly involved. More precisely, aortic valve (AV) rings area; native or prosthetic valve is usually affected. Occurrence of myocardial abscess within free wall of the left ventricle (LV) without any evidence of infective endocarditis is a rare phenomenon; and infrequently reported in medical literature. We report a case of myocardial abscess cavity within the anterior wall of the LV, in a patient who underwent open heart surgery for severe AV stenosis. This was an incidental intraoperative transesophageal echocardiography (TEE) finding without any other evidence of infective endocarditis. The stenotic AV was replaced, along with surgical drainage and closure of the cavity. Postoperatively, patient was managed on empirical antibiotics according to infective endocarditis guidelines.

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“…The first was at the NCC-LCC commissure and the other on top of the right coronary cusp. The patient had AV (25 mm mechanical valve) and ascending aorta (26 mm Dacron graft) replacement under standard CPB technique [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Incidental Diagnosis of Healed Aortic Abscess Cavity

Shree¹,

Palanisamy²,

Chidambaram³

et al. 2021

Cureus

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In infective endocarditis, the perivalvular abscess is a known complication with an incidence of more than 22%-29%, but the primary presentation of a healed aortic abscess without any clinical features of infective endocarditis is very rare. These sorts of cases are scarcely documented throughout literature. We present a successful surgical closure of healed perivalvular abscess cavity with aortic valve replacement and mitral valve repair.

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Healed perivalvular abscess: Incidental finding on transthoracic echocardiography

Cited by 5 publications

References 16 publications

Occult deterioration of an aortic annular abscess: how do we diagnose a pseudoaneurysm periaortic valve? A case report

Occult deterioration of an aortic annular abscess: how do we diagnose a pseudoaneurysm periaortic valve? A case report

Isolated myocardial abscess cavity

Incidental Diagnosis of Healed Aortic Abscess Cavity

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