title: Aortocavitary fistula without aneurysm and transient incomplete atrioventricular block due to infective endocarditis.
abstract: A 67-year-old man with persistent fever and moderate aortic valve regurgitation was transferred. He suffered from incomplete atrioventricular block (AVB), and temporary pacing was needed. Left-to-right shunt flow from the aorta to the right atrium was found without an aneurysm. Operative findings indicated that the aortic valve was highly calcified. The orifice of an aortocavitary fistula (ACF) was detected in the sinus of Valsalva and the right atrium. Patch repair of the aortic annulus with complete débridement of the abscess cavity was performed, a procedure that consisted of aortic valve replacement directly to the Gore-Tex patch and aortic root replacement. His postoperative course was uneventful, but a pacemaker was implanted owing to complete AVB. To our knowledge, this is a rare case in which infective endocarditis was complicated by ACF without an aneurysm of the sinus of valsalva (SV) on the noncoronary cusp to the right atrium and transient incomplete AVB (Mobitz type II) occurring simultaneously.
authors.affiliation: Department of Cardiovascular Surgery, Saiseikai Nakatsu Hospital Osaka, 2-10-39 Shibata Kita-ku, Osaka 530-0012, Japan. tkawahira-circ@umin.ac.jp
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kawahira
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Iwahashi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Okada
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000628:therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001018:Aortic Diseases / Q000382:microbiology* / Q000628:therapy; D001022:Aortic Valve Insufficiency / Q000382:microbiology* / Q000628:therapy; D054537:Atrioventricular Block / Q000382:microbiology* / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D003131:Combined Modality Therapy; D003646:Debridement; D004696:Endocarditis / Q000150:complications / Q000382:microbiology* / Q000628:therapy; D006325:Heart Atria / Q000382:microbiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva / Q000382:microbiology* / Q000601:surgery; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000382:microbiology* / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents