Infective endocarditis with an aortic periannular abscess extending along the right coronary artery.
A 50-year-old male underwent surgery for infective aortic valve endocarditis, which had been refractory to medical treatment. The valve was bicuspid, and involvement of the annular and subannular structures was recognized. A large suppurative discharge was obtained on incising this portion. Although there was no interventricular shunt, the abscess cavity was revealed to extend through the epicardial surface of the right atrioventricular groove. Following extensive debridement and irrigation, the defect was closed by an autologous pericardial patch. A 23 mm mechanical valve was implanted placing some of the stitches deep into the muscular interventricular septum. Infection was controlled by six-week administration of cefazolin sodium and gentamicin sulfate, and the patient survived.
Saito
Shunei
S
Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, Japan.
Usui
Akihiko
A
Akita
Toshiaki
T
Oshima
Hideki
H
Yoshioka
Terumasa
T
Ueda
Yuichi
Y
D000038:Abscess / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001705:Bioprosthesis; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery*; D003646:Debridement; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000188:drug therapy / Q000601:surgery*; D006331:Heart Diseases / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D006349:Heart Valve Diseases / Q000382:microbiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000601:surgery*
D000900:Anti-Bacterial Agents