title: Refractory ascites - a rare presentation of severe aortic regurgitation.
abstract: A 47 year-old male with a history of refractory ascites presented to our centre complaining of dyspnoea, abdominal distention, and weight gain. He was admitted under a medical team for investigation and management. Work-up excluded all common aetiologies of ascites. Echocardiography revealed severe aortic regurgitation (AR) with a dilated left ventricle but no right heart pathology or pulmonary hypertension. He underwent mechanical aortic valve replacement. Intra-operatively, a prolapsing left coronary leaflet of the aortic valve with frayed edges raised suspicion of resolved infective endocarditis. Postoperative course was uneventful. Following replacement of the aortic valve, the patient was completely free of ascites. This case demonstrates that ascites can be an unusual clinical presentation of severe aortic regurgitation, which may respond to aortic valve replacement.
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Perth, Western Australia, Australia.
authors.forename: Charles
authors.initials: C
authors.lastname: Jenkinson
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Perth, Western Australia, Australia.
authors.forename: Shanker
authors.initials: S
authors.lastname: Rajaratnam
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Perth, Western Australia, Australia.
authors.forename: Pragnesh
authors.initials: P
authors.lastname: Joshi
authors.affiliation: Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Hospital Avenue, Perth, Western Australia, Australia. Electronic address: jurgen.passage@health.wa.gov.au.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Passage
mesh_terms: D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D001201:Ascites / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D004108:Dilatation, Pathologic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D004452:Echocardiography; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged
keywords: Aortic valve insufficiency; Aortic valve replacement; Ascites