title: Unusual cause of myocardial infarction and congestive heart failure in a patient with prosthetic valve endocarditis.
abstract: In a patient with staphylococcus lugdunensis prosthetic aortic valve endocarditis and coronary septic embolism accompanied by antero-lateral myocardial infarction, embolic material was successfully aspirated from the bifurcation of the left anterior descending coronary artery and the first diagonal branch. A good angiographic result was documented six months thereafter when the patient presented with a second complication, pulsatile compression of the left main coronary artery by an abscess cavity originating between the aortic and mitral annulus, leading to congestive heart failure. The patient underwent successful surgical replacement of the aortic valve prosthesis with concomitant patch reconstruction of the annulus as well as tricuspid annuloplasty.
authors.affiliation: Department of Cardiology, Inselspital, University Hospital Bern & University of Bern, Bern, Switzerland; Department of Intensive Care Medicine, Inselspital, University Hospital Bern & University of Bern, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Bloechlinger
authors.forename: Mathias
authors.initials: M
authors.lastname: Nebiker
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
mesh_terms: D000328:Adult; D058385:Cardiac Valve Annuloplasty; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D020878:Device Removal; D004617:Embolism / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D012086:Reoperation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D057787:Staphylococcus lugdunensis / Q000302:isolation & purification*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013396:Suction; D013997:Time Factors; D016896:Treatment Outcome
keywords: abscess; aspiration; compression; embolus; left main coronary artery; septic