RESUMO
Coronary artery fistula (CAF) is characterized as a congenital or acquired abnormal communication between a coronary artery and any of the four chambers of the heart (coronary-cameral fistula) or great vessels (coronary arteriovenous fistula) bypassing the capillaries within myocardium. CAF is a rare disease, challenging to diagnose and treat depending on the anatomical location and type of the fistula and accompanying diseases. This study aims to report a case with multiple coronary artery to coronary sinus (CS) fistulas with giant left circumflex artery and multivalvular infective endocarditis.
Assuntos
Fístula Arteriovenosa , Doença da Artéria Coronariana , Seio Coronário , Anomalias dos Vasos Coronários , Endocardite Bacteriana , Endocardite , Humanos , Seio Coronário/diagnóstico por imagem , Seio Coronário/cirurgia , Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/cirurgia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Doença da Artéria Coronariana/complicações , Endocardite/complicações , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgiaRESUMO
A 60-year-old man presented with breathlessness. Nearly four decades previously, he had required three operations for Staphylococcus aureus infective endocarditis of the tricuspid valve and had received a bioprosthetic valve. He had critical tricuspid bioprosthesis stenosis which was treated successfully by valve-in-valve transcatheter tricuspid valve replacement using a balloon-expandable transcatheter heart valve. One year after intervention, the patient is well with no tricuspid valve stenosis or regurgitation.
Assuntos
Bioprótese , Endocardite Bacteriana , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Estenose da Valva Tricúspide , Masculino , Humanos , Pessoa de Meia-Idade , Adulto , Bioprótese/efeitos adversos , Constrição Patológica , Valva Tricúspide/diagnóstico por imagem , Valva Tricúspide/cirurgia , Estenose da Valva Tricúspide/diagnóstico por imagem , Estenose da Valva Tricúspide/cirurgia , Próteses Valvulares Cardíacas/efeitos adversos , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Resultado do Tratamento , Desenho de Prótese , Falha de PróteseRESUMO
Heart valve replacement has steadily increased over the past decades due to improved surgical mortality, an aging population, and the increasing use of transcatheter valve technology. With these developments, prosthetic valve complications, including prosthetic valve endocarditis, are increasingly encountered. In this review, we aim to characterize the manifestations of prosthetic valve endocarditis using representative case studies from our institution to highlight the advances and contributions of modern multimodality imaging techniques.
Assuntos
Endocardite Bacteriana , Endocardite , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Infecções Relacionadas à Prótese , Humanos , Idoso , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/terapia , Próteses Valvulares Cardíacas/efeitos adversos , Endocardite/diagnóstico por imagem , Endocardite/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Imagem Multimodal , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/terapiaRESUMO
In this retrospective/prospective study, we assessed the role of fundoscopy in 711 episodes with suspected infective endocarditis (IE); 238 (33%) had IE. Ocular embolic events (retinal emboli or chorioretinitis/endophthalmitis) and Roth spots were found in 37 (5%) and 34 (5%) episodes, respectively, but had no impact on IE diagnosis.
Assuntos
Embolia , Endocardite Bacteriana , Endocardite , Humanos , Estudos de Coortes , Estudos Retrospectivos , Estudos Prospectivos , Endocardite/diagnóstico , Endocardite Bacteriana/diagnóstico por imagemRESUMO
BACKGROUND: Right-sided infective endocarditis (RSIE) is a relatively uncommon condition which is difficult to distinguish from thrombus, particularly when the site of infection or the patient's symptoms are atypical. There have been few reports exploring the differential diagnostic and analytical features between RSIE and thrombus. CASE PRESENTATION: Here, we presented two cases of RSIE-one involving the tricuspid valve and the other affecting the pulmonary artery. Notably, the second case was initially misdiagnosed as thrombus based on the findings of by computed tomography angiography(CTA). CONCLUSIONS: Vegetation and thrombus can be distinguished according to the nature of the mass, its attachment location, and the clinical manifestation. Echocardiography can observe both the location and size of the mass, and the dynamic changes in cardiac hemodynamics and cardiac morphology, thereby facilitating an effective distinction between vegetation and thrombus.
Assuntos
Endocardite Bacteriana , Endocardite , Trombose , Humanos , Endocardite/diagnóstico por imagem , Ecocardiografia , Valva Tricúspide/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Trombose/diagnóstico por imagem , Endocardite Bacteriana/diagnóstico por imagemAssuntos
Mergulho , Endocardite Bacteriana , Endocardite , Cardiopatias , Humanos , Mergulho/efeitos adversos , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagem , Antibacterianos/uso terapêutico , Cardiopatias/tratamento farmacológico , Endocardite/etiologia , Endocardite/tratamento farmacológicoRESUMO
A 68-year-old male patient was admitted for extremities edema and diagnosed with infective endocarditis (IEIE). The patient underwent mitral and aortic valve mechanical valve replacement due to rheumatic heart valve disease 26 years ago. He underwent mechanical aortic valve and bioprosthetic tricuspid valve replacement due to mechanical aortic valve dysfunction and severe tricuspid valve regurgitation 1 year ago. Two months ago, the patient underwent emergency permanent pacemaker implantation due to syncope caused by a third-degree atrioventricular block. The patient was admitted to the emergency with fever and worsening dyspnea 1 h ago. Transthoracic echocardiography revealed prosthetic aortic valve severe paravalvular leak and tricuspid valve stenosis with vegetation. The patient was scheduled to undergo mechanical aortic valve and bioprosthetic tricuspid valve replacement under median thoracotomy. The intraoperative transesophageal echocardiography (TEE) view showed severe paravalvular aortic valve leakage and tricuspid valve vegetation. The coronary sinus was significantly enlarged with thrombus formation, vegetation can be seen in the bioprosthetic tricuspid valve leaflets. This is a rare case of infective endocarditis with tricuspid stenosis and coronary sinus thrombosis after the placement of implanted pacemakers.
Assuntos
Endocardite Bacteriana , Endocardite , Implante de Prótese de Valva Cardíaca , Marca-Passo Artificial , Estenose da Valva Tricúspide , Masculino , Humanos , Idoso , Estenose da Valva Tricúspide/diagnóstico por imagem , Estenose da Valva Tricúspide/etiologia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagem , Endocardite/complicações , Endocardite/diagnóstico por imagem , Marca-Passo Artificial/efeitos adversosRESUMO
Mitral valve aneurysm (MVA) is characterized by a saccular outpouching of the mitral leaflet, and it represents a rare condition typically associated with aortic valve endocarditis. Three-Dimensional Transesophageal Echocardiography (3D-TEE) serves as an effective tool for detecting the presence of MVA and its potential complications. In this report, we present a case involving a young man with striking images of bicuspid aortic valve endocarditis complicated by an aortic root abscess and multiple perforated mitral valve aneurysms, diagnosed using 3D TEE. This case suggests the uncommon coexistence of Marfan like morphotype, bicuspid aortic valve, and infective endocarditis as a triple mechanism in the occurrence of MVA. It underscores the significance of early and accurate imaging diagnosis for facilitating prompt surgical intervention.
Assuntos
Doença da Válvula Aórtica Bicúspide , Ecocardiografia Tridimensional , Endocardite Bacteriana , Endocardite , Aneurisma Cardíaco , Síndrome de Marfan , Humanos , Masculino , Abscesso/diagnóstico por imagem , Abscesso/etiologia , Aorta Torácica , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Doença da Válvula Aórtica Bicúspide/complicações , Ecocardiografia Transesofagiana/métodos , Endocardite/complicações , Endocardite/diagnóstico por imagem , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/complicações , Síndrome de Marfan/complicações , Síndrome de Marfan/diagnóstico , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgiaAssuntos
Endocardite Bacteriana , Endocardite , Próteses Valvulares Cardíacas , Infecções Relacionadas à Prótese , Humanos , Ecocardiografia Transesofagiana , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Endocardite Bacteriana/diagnóstico por imagem , Próteses Valvulares Cardíacas/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/etiologiaAssuntos
Candidíase , Endocardite Bacteriana , Endocardite , Próteses Valvulares Cardíacas , Humanos , Candida , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Endocardite/diagnóstico por imagem , Endocardite/etiologia , Endocardite/tratamento farmacológico , Candidíase/diagnóstico , Candidíase/diagnóstico por imagem , Antifúngicos/uso terapêuticoRESUMO
BACKGROUND: To determine the prevalence, the clinical and radiological features, associated factors, treatment, and outcome of splenic artery aneurysms (SAAs) in infective endocarditis (IE). METHODS: We retrospectively reviewed 474 consecutive patients admitted to our institution with definite IE (2005-2020). RESULTS: Six patients had SAAs (1.3%; 3 women; mean age: 50 years). In all cases, the diagnosis was obtained by abdominal computed tomography angiography (CTA). SAAs-IE were solitary and saccular with a mean diameter of 30 mm (range: 10-90 mm). SAAs-IE were intrasplenic (n = 4) or hilar (n = 2). Streptococcus spp. were the predominant organisms (n = 4). In all cases, a left-sided native valve was involved (aortic, n = 3; mitral, n = 2; mitral-aortic, n = 1). SAAs were silent in half patients and were revealed by abdominal pain (n = 2) and by the resurgence of fever after cardiac surgery (n = 1). All patients underwent emergent valve replacement. One patient died within 24 hr from multiorgan failure. For the others, uneventful coil embolization was performed in 4 patients after valve replacement (3 diagnosed early and 1 at 8 weeks). In the remaining patient, SAA-IE diagnosed at abdominal CTA at day 16, with complete resolution under appropriate antibiotherapy alone. CONCLUSIONS: SAAs-IE are a rare occurrence that may be clinically silent. SAAs-IE can be intrasplenic or hilar in location. Endovascular treatment in this context was safe. According to current guidelines, radiologic screening by abdominal CTA allowed the detection of silent SAAs which could be managed by endovascular treatment to prevent rupture. The delayed formation of these SAAs could justify a CTA control at the end of antibiotherapy.
Assuntos
Aneurisma , Doenças Transmissíveis , Endocardite Bacteriana , Endocardite , Humanos , Feminino , Pessoa de Meia-Idade , Artéria Esplênica/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento , Aneurisma/terapia , Aneurisma/cirurgia , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/terapia , Endocardite/diagnóstico por imagem , Endocardite/terapia , Estudos Observacionais como AssuntoAssuntos
Bacteriemia , Endocardite Bacteriana , Endocardite , Infecções Estafilocócicas , Humanos , Staphylococcus aureus , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/diagnóstico por imagem , Ecocardiografia Transesofagiana , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/diagnóstico , Bacteriemia/diagnóstico , Fatores de RiscoRESUMO
A 39-year-old man was presented with infective endocarditis caused by Abiotrophia defectiva. Transesophageal echocardiography revealed extensive vegetation and destruction extending from the aortic valve to the aortic-mitral curtain and mitral valve accompanied by severe regurgitation of the aortic and mitral valves. After removal of vegetation, double-valve replacement were performed with double patch and mechanical prosthesis using the manouguian procedure.
Assuntos
Endocardite Bacteriana , Endocardite , Infecções por Bactérias Gram-Positivas , Implante de Prótese de Valva Cardíaca , Masculino , Humanos , Adulto , Infecções por Bactérias Gram-Positivas/diagnóstico por imagem , Infecções por Bactérias Gram-Positivas/cirurgia , Infecções por Bactérias Gram-Positivas/complicações , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/cirurgia , Endocardite Bacteriana/complicações , Endocardite/cirurgia , Implante de Prótese de Valva Cardíaca/métodosAssuntos
Endocardite Bacteriana , Cardiopatias Congênitas , Infecções Estreptocócicas , Humanos , Streptococcus sanguis , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/tratamento farmacológico , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/tratamento farmacológico , Coração , Cardiopatias Congênitas/complicaçõesAssuntos
Endocardite Bacteriana , Endocardite , Implante de Prótese de Valva Cardíaca , Insuficiência da Valva Mitral , Neoplasias , Humanos , Valva Mitral/diagnóstico por imagem , Valva Mitral/cirurgia , Endocardite/complicações , Endocardite/diagnóstico por imagem , Endocardite/cirurgia , Insuficiência da Valva Mitral/cirurgia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/diagnóstico por imagemRESUMO
We present a case of a febrile patient in his 70s who was found to have isolated native pulmonary valve vegetations on echocardiography, and Enterococcus faecalis on blood cultures. Of note, our patient had none of the typical risk factors associated with this rare form of endocarditis previously described in only a handful of case reports.