Case of the winter season: mycotic aneurysms complicating bacterial endocarditis.
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We report two cases of subvalvular aortic stenosis associated with a postendocarditic aortic valvular insufficiency. Although the aortic valvular disease had been diagnosed preoperatively, only the direct intraoperative observation and the histological examination of the removed valve revealed evidence of the endocarditis. Because of the seriously altered condition of the valvular tissue, treatment in both cases consisted of implantation of a mechanical prosthesis. Follow-up revealed no evidence of septic relapse.
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We report a case of definite Lactococcus garvieae native-valve endocarditis. The diagnosis was suspected in a patient presenting with congestive heart failure and found to have Enterococcus hirae bacteremia, with a history of L. garvieae bacteremia 1 month prior. Diagnosis was confirmed by 16S rRNA gene sequencing of the 2 isolates and the demonstration of aortic valve vegetations.
Coronary artery fistula is often considered to be a benign and rare congenital anomaly. It is usually an incidental finding encountered during routine cardiac catheterization. We report a case of a patient presenting with endocarditis involving a large coronary artery fistula connecting an aneurysmal circumflex coronary artery to the coronary sinus. The diagnosis was initially made by echocardiography and confirmed by cardiac catheterization. In addition, we briefly discuss the literature on management of this coronary anomaly.
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A composite valve prosthesis was prepared by direct suture of the ring prosthesis, which was separated from an intraluminal ringed graft, with a St. Jude Medical aortic valve. A new translocation method using this composite valve prosthesis was performed on a patient with aortic periannular abscess, with favorable result.