The ultimate development of mitral valve endocarditis: atrioventricular separation, atrioventricular groove abscess and hemorrhagic pericarditis.
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.
Atik
Fernando A
FA
Departments of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Pettersson
Gosta B
GB
Sigurdsson
Gardar
G
Gonzalez-Stawinski
Gonzalo V
GV
Sabik
Ellen Mayer
EM
Kim
Alice
A
Svensson
Lars G
LG
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