title: Kissing ulcer of the aortic wall in a patient with aortic valve endocarditis.
abstract: In patients with aortic valve endocarditis, lesion of the mitral valve leaflets caused by jet strike or vegetation touch (kissing) is a well-described complication. We present a case of infectious aortic ulcer caused by aortic valve vegetation kissing. A 72-year-old woman who underwent operation for Streptococcus viridans aortic valve endocarditis presented with a "kissing ulcer" in the aortic wall disclosed by intraoperative transesophageal echocardiography. The aortic valve was replaced by a bileaflet prosthesis, and the ulcer was closed with a small patch of autologous pericardium after thorough inspection. Transesophageal echocardiography performed before discharge showed a good surgical result without signs of infection recurrence. To the best of our knowledge, this is the first report of aortic wall involvement by the mechanism described.
authors.affiliation: Center of Thoracic Surgery, S. João Hospital, Oporto, Portugal.
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia
authors.forename: Albino
authors.initials: A
authors.lastname: Santos
authors.forename: Jorge
authors.initials: J
authors.lastname: Almeida
authors.forename: Paulo
authors.initials: P
authors.lastname: Pinho
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery; D001025:Aortitis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D013290:Streptococcal Infections / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography