Erschienen in:
01.04.2015 | Image of the month
Bicuspid aortic valve endocarditis complicated by ruptured sinus of Valsalva aneurysm
verfasst von:
Z. Wang, J. Hu, Y. Qin, Prof. X. Zhao
Erschienen in:
Herz
|
Sonderheft 2/2015
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Excerpt
A 21-year-old man was admitted to our hospital with a high fever of 2-week duration. On physical examination, a grade 3/6 continuous murmur was heard in the left lower sternal border. Laboratory investigations revealed leukocytosis (white blood cell count, 29,800 /mm
3; neutrophils, 90 %) along with elevated C-reactive protein levels (45.1 mg/dl). Transthoracic echocardiography showed a bicuspid aortic valve (BAV) accompanied by perivalvular abscess; multiple vegetations of the aortic leaflet (14 × 12 mm) and anterior mitral leaflet (9 × 8 mm) were found. A ruptured sinus of Valsalva aneurysm (SOVA) originating from the noncoronary sinus and communicating with the right atrium was seen. Color Doppler imaging confirmed the presence of an aorto-right atrial fistula (
Fig. 1). The patient was transferred to the cardiothoracic surgery unit and prepared for surgery. The severely damaged valves were excised and replaced with mechanical valves, and the aneurysm was repaired with a bovine pericardial patch. After surgery, the patient was given intravenous antibiotics for 6 weeks. His postoperative course was uneventful. He was doing well at the 3-month follow-up visit. …