title: The ultimate development of mitral valve endocarditis: atrioventricular separation, atrioventricular groove abscess and hemorrhagic pericarditis.
abstract: A 52-year-old non-insulin-dependent diabetic man presented with cerebral emboli and mitral valve endocarditis with posterior leaflet vegetations and perforation. Surgical intervention demonstrated hemorrhagic pericarditis and an atrioventricular groove abscess. Extensive debridement of the pericardium, valve and abscess cavities, reconstruction of the mitral annulus with a patch of fresh autologous pericardium, and mitral valve replacement with a pericardial bioprosthesis was performed. The chest was left open. Postoperatively, the patient required dialysis and prolonged mechanical ventilation, but recovered well without recurrent endocarditis and was discharged home after 40 days.
authors.affiliation: Departments of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Atik
authors.forename: Gosta B
authors.initials: GB
authors.lastname: Pettersson
authors.forename: Gardar
authors.initials: G
authors.lastname: Sigurdsson
authors.forename: Gonzalo V
authors.initials: GV
authors.lastname: Gonzalez-Stawinski
authors.forename: Ellen Mayer
authors.initials: EM
authors.lastname: Sabik
authors.forename: Alice
authors.initials: A
authors.lastname: Kim
authors.forename: Lars G
authors.initials: LG
authors.lastname: Svensson
mesh_terms: D000038:Abscess / Q000382:microbiology*; D001283:Atrioventricular Node / Q000382:microbiology*; D001705:Bioprosthesis; D003646:Debridement; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006470:Hemorrhage / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology* / Q000601:surgery; D010493:Pericarditis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D010496:Pericardium / Q000637:transplantation; D006435:Renal Dialysis; D012121:Respiration, Artificial; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery; D013211:Staphylococcus aureus; D020521:Stroke / Q000175:diagnosis