title: Prosthetic aortic valve endocarditis complicated with annular abscess, sub-aortic obstruction and valve dehiscence.
abstract: We present a 76-year-old woman with infective endocarditis of a prosthetic aortic valve. The course of her illness started with an ischaemic stroke and she was admitted with prolonged fever and an episode of loss of consciousness. Echocardiography revealed acute aortic regurgitation and dehiscence of the prosthetic valve with excessive "rocking motion", aortic abscesses and left ventricular outflow obstruction caused by a semilunar shelf of tissue probably due to endocarditis vegetations. She underwent an urgent surgical procedure that confirmed the echocardiographic findings. Our case report reinforces the value of early diagnosis in the presence of a high clinical suspicion of prosthetic valve endocarditis. An extended workup, including transoesophageal echocardiography, in such a patient with a mechanical valve is mandatory.
authors.affiliation: Cardiac Surgery and Heraklion University Hospital Crete, Greece. cardio@med.uoc.gr
authors.forename: Joannis
authors.initials: J
authors.lastname: Hassoulas
authors.forename: Alexandros P
authors.initials: AP
authors.lastname: Patrianakos
authors.forename: Fragiskos I
authors.initials: FI
authors.lastname: Parthenakis
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology*; D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging; D017809:Fatal Outcome; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000000981:diagnostic imaging; D011662:Pulmonary Subvalvular Stenosis / Q000000981:diagnostic imaging / Q000209:etiology*