title: Commissure avulsion of the aortic valve caused by purulent pericarditis: report of a case.
abstract: A 20-year-old man with fever and chest pain was referred to our hospital, where purulent pericarditis was confirmed by various examinations. Hemodynamic collapse and acute pulmonary edema occurred 1 week later, caused by acute severe aortic valvular regurgitation (AR). Emergency surgery revealed that the AR had been caused by avulsion of the aortic valvular commissure, which seemed to have resulted from penetration of the pericardial inflammatory process to the aortic root. We report this case because purulent pericarditis is now relatively uncommon and resultant aortic commissure avulsion is even rarer.
authors.affiliation: Department of Cardiovascular Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuoku, Tokyo, 104-8560, Japan, manayama@luke.or.jp.
authors.forename: Manabu
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Sunao
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kohei
authors.initials: K
authors.lastname: Abe
authors.forename: Kohei
authors.initials: K
authors.lastname: Kawazoe
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001021:Aortic Valve / Q000473:pathology* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D002437:Cefazolin / Q000008:administration & dosage; D004630:Emergencies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010493:Pericarditis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D011654:Pulmonary Edema / Q000209:etiology; D012769:Shock / Q000209:etiology; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes / Q000302:isolation & purification; D013492:Suppuration; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin