title: Endocarditis with massive aortic root abscess and atrioventricular septal destruction.
abstract: Endocarditis involving the aortic root and intervalvular fibrous skeleton presents a reconstructive dilemma. We report a case of endocarditis involving the aortic root and tricuspid valve with extensive destruction of the atrioventricular septum. Debridement necessitated resection of the aortic root, aortic valve, tricuspid valve, and a large portion of atrioventricular septum, leaving the right atrium, right ventricle, left ventricle and aorta in open communication. Reconstruction was accomplished by separating the left and right hearts with a Dacron patch, tricuspid valve replacement, and aortic root replacement. Proper planar localization of the aortic root was necessary to avoid left ventricular outflow obstruction and coronary torsion.
authors.affiliation: Division of Cardiothoracic Surgery, University of Pennsylvania Medical Center, Philadelphia, PA 19104, USA.
authors.forename: Landi M
authors.initials: LM
authors.lastname: Parish
authors.forename: Liming
authors.initials: L
authors.lastname: Liu
authors.forename: Y Joseph
authors.initials: YJ
authors.lastname: Woo
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D054087:Atrial Septum / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D003646:Debridement; D004697:Endocarditis, Bacterial / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000382:microbiology / Q000601:surgery; D014463:Ultrasonography; D054088:Ventricular Septum / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery