Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

Zegri-Reiriz, Isabel; Alarcón, Arı́stides de; Muñóz, Patricia; Sellés, Manuel Martínez; Ramallo, Víctor José González; Miró, José M.; Falces, Carles; Rico, Claudia González; Urkola, Xabier Kortajarena; Lepe, José Antonio; Álvarez, Regino Rodríguez; Iglesias, J M Reguera; Navas, Enrique; Domínguez, Fernándo; García‐Pavía, Pablo

doi:10.1016/j.jacc.2018.03.534

Cited by 73 publications

(43 citation statements)

References 39 publications

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“…In 2007, the American Heart Association (AHA) removed two prior cardiac conditions for endocarditis prophylaxis [8]. Patients with mitral valve prolapse and bicuspid aortic valve (BAV) are now restricted from prophylactic antibiotic use; however, recent data show Case Reports in Infectious Diseases an increased incidence of infective endocarditis within this population with an increased risk of perivalvular extension with abscess formation [9,10]. Based on congenital valvular literature, BAV is the most common congenital heart disease with estimated prevalence of around 0.5-2.0% [10].…”

Section: Discussionmentioning

confidence: 99%

Dermatologic Conundrum: A Cardiac Condition Masqueraded as a Dermatologic Distraction

Degheim

Hiner

Berry

et al. 2020

Case Reports in Infectious Diseases

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A 38-year-old male presented to the emergency department (ED) complaining of extreme pain and a petechial rash on the left ankle for two weeks associated with generalized fatigue, intermittent fevers, and weight loss. He was discharged home from the ED on pain medications. He returned a few days later with a progressive rash that involved the entire left lower extremity to the level of the knee. He was diagnosed with herpes zoster (shingles) and was prescribed acyclovir and steroids. After several days, the patient presented for the third time to the ED. He developed a right lower extremity discomfort this time. The pain in bilateral lower extremities had become unbearable. His cardiac examination revealed a systolic murmur at the apex and a faint diastolic murmur at the left sternal border. Ultimately, he had an echocardiogram that demonstrated both a bicuspid aortic valve and large vegetation on the anterior leaflet of the mitral valve, and his blood culture grew Streptococcus mitis and Streptococcus oralis. The patient was subsequently diagnosed with subacute bacterial endocarditis thought to be sourced from his poor dentition. The diagnosis of infective endocarditis is often delayed due to its nonspecific clinical presentations. Our case displays an unusual skin manifestation of IE that may be present in the absence of other signs and symptoms of the disease.

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Section: Discussionmentioning

confidence: 99%

Dermatologic Conundrum: A Cardiac Condition Masqueraded as a Dermatologic Distraction

Degheim

Hiner

Berry

et al. 2020

Case Reports in Infectious Diseases

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“…On the other hand, patients with pure aortic regurgitation seemed to demonstrate preference for younger age, male gender, and RL fusion type, and were inclined to develop aortic root dilatation. As a potentially devastating complication, infective endocarditis remains a big challenge, 21) especially among young regurgitant BAV patients. The occurrence of endocarditis was 3.2% in the present study, which was in agreement with a recent cross-sectional study by Li et al 22) Similar incidences could be found in follow-up studies by Michelena, et al and Tzemos, et al in 2008, while Roberts reported a much higher occurrence in his pilot BAV autopsy study in 1970.…”

Section: Discussionmentioning

confidence: 99%

Distribution Patterns of Valvular and Vascular Complications in Bicuspid Aortic Valve

Wang

et al. 2020

Int. Heart J.

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For its high occurrence and elevated risks for aortic valve dysfunction and vascular complications, bicuspid aortic valve (BAV) represents a great health challenge. However, the prevalence and clinical features of BAV in the Chinese population are inadequately illustrated. From January 2011 to December 2015, 3,673 BAV patients with 69.1% male predominance were identified among 325,910 recipients of transthoracic echocardiography in our institution, demonstrating 58.4% overt aortic valve dysfunction, 52.5% ascending aortic dilatation, and 19.2% aortic root dilatation. The prevalence of pure aortic stenosis and mixed aortic valve dysfunction rose strikingly with age (both P < 0.0001), while pure aortic regurgitation showed significant decrease with age (P < 0.0001). Males showed elevated prevalence of pure aortic regurgitation (OR 3.16, 95% CI 2.55-3.91, P < 0.0001) and mixed aortic valve dysfunction than females (OR 1.63, 95% CI 1.23-2.17, P = 0.0008), but lower prevalence of pure aortic stenosis (OR 0.51, 95% CI 0.43-0.60, P < 0.0001). Aortic root dilatation was associated with male gender (OR 5.02, 95% CI 3.74-6.74, P < 0.0001), pure aortic regurgitation (OR 2.61, 95% CI 2.15-3.17, P < 0.0001), and right-left (RL) cusp fusion type (OR 1.98, 95% CI 1.64-2.40, P < 0.0001). Ascending aortic dilatation was associated with an elder age (OR 1.04, 95% CI 1.04-1.05, P < 0.0001), pure aortic stenosis (OR 1.37, 95% CI 1.16-1.61 P = 0.0002), and mixed aortic valve dysfunction (OR 2.51, 95% CI 1.89-3.33, P < 0.0001). Bicuspid aortic stenosis and ascending aortic dilatation demonstrate a similar pattern of age escalation, while aortic regurgitation is more prevalent in younger BAV patients. Aortic root dilatation intervenes closely with a unique phenotypic subgroup of male BAV patients with pure aortic regurgitation and RL fusion type.

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“…The majority of BAV with IE were men. Adverse events of IE included heart failure, peripheral embolism, embolic stroke, persistent bacteremia, and intracardiac complications (Chambers, 2018; Zegri-Reiriz et al, 2018).…”

Section: Infective Endocarditis: Antibiotic Prophylaxis Comes Firstmentioning

confidence: 99%

Bicuspid Aortic Valve: An Update in Morphology, Genetics, Biomarker, Complications, Imaging Diagnosis and Treatment

Liu

Xie

et al. 2019

Front. Physiol.

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The bicuspid aortic valve, a kind of heart disease that comes from parents, has been paid attention around the world. Although most bicuspid aortic valve (BAV) patients will suffer from some complications including aortic stenosis, aortic regurgitation, endocarditis, and heart dysfunction in the late stage of the disease, there is none symptom in the childhood, which restrains us to diagnose and treatment in the onset phase of BAV. Hemodynamic abnormalities induced by the malformations of the valves in BAV patients for a long time will cause BAV-associated aortopathy: including progress aortic dilation, aneurysm, dissection and rupture, cardiac cyst and even sudden death. At present, preventive surgical intervention is the only effective method used in this situation and the diameter of the aorta is the primary reference criterion for surgery. And the treatment effects are always not satisfactory for patients and clinicians. Therefore, we need more methods to evaluate the progression of BAV and the surgery value and the appropriate intervention time by combining basic research with clinical treatment. In this review, advances in morphology, genetic, biomarkers, diagnosis and treatments are summarized, which expects to provide an update about BAV. It is our supreme expectations to provide some evidences for BAV early screening and diagnosis, and in our opinion, personalized surgical strategy is the trend of future BAV treatment.

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Infective Endocarditis in Patients With Bicuspid Aortic Valve or Mitral Valve Prolapse

Cited by 73 publications

References 39 publications

Dermatologic Conundrum: A Cardiac Condition Masqueraded as a Dermatologic Distraction

Dermatologic Conundrum: A Cardiac Condition Masqueraded as a Dermatologic Distraction

Distribution Patterns of Valvular and Vascular Complications in Bicuspid Aortic Valve

Bicuspid Aortic Valve: An Update in Morphology, Genetics, Biomarker, Complications, Imaging Diagnosis and Treatment

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