title: Acute aortic dissection associated with undetected congenital bicuspid aortic valve and infective endocarditis diagnosed intraoperatively.
abstract: The congenital bicuspid aortic valve (BAV) is recognized as a cause of acute aortic dissection (AAD) and also as a risk factor for infective endocarditis (IE) especially ring abscess. We experienced a case of all these combined and operated emergently. A 59-year-old man was transferred to us, and emergent operation was indicated for AAD and aortic stenosis (AS) due to BAV. However, he was strongly suspected of also having IE during the operation and the procedure was changed to a modified Bentall's method. The diagnosis was confirmed by pathological examination postoperatively. He recovered well after postoperative antimicrobial therapy without recurrent infection. It is important to remember that BAV is a risk factor for not only AAD but also IE, which sometimes occurs simultaneously and requires an emergent operation due to high mortality.
authors.affiliation: Division of Cardiovascular Surgery, Miyazaki Medical Association Hospital, Miyazaki, Japan. berry@mui.biglobe.ne.jp
authors.forename: Shizuko
authors.initials: S
authors.lastname: Iwasa
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Sayaka
authors.initials: S
authors.lastname: Moriguchi-Goto
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000209:etiology* / Q000601:surgery; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000209:etiology* / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D003646:Debridement; D004696:Endocarditis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents