title: Sinus of Valsalva Pseudoaneurysm as a Sequela to Infective Endocarditis.
abstract: Pseudoaneurysm is an uncommon sequela of infective endocarditis. We treated a 44-year-old man who had an active case of group B streptococcal infective endocarditis of the aortic valve despite no evidence of valvular dysfunction or vegetation on his initial transesophageal echocardiogram. After completing 6 weeks of intravenous antibiotic therapy, the patient developed a sinus of Valsalva pseudoaneurysm and severe aortic regurgitation caused by partial detachment of the left coronary cusp. We used a pericardial patch to close the pseudoaneurysm and repair the coronary cusp. This case shows the importance of routine clinical follow-up evaluation in infective endocarditis, even after completion of antibiotic therapy. Late sequelae associated with infective endocarditis or its therapy include recurrent infection, heart failure caused by valvular dysfunction (albeit delayed), and antibiotic toxicity such as aminoglycoside-induced nephropathy and vestibular toxicity.
authors.forename: Chin C
authors.initials: CC
authors.lastname: Lee
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Siegel
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008297:Male; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging*; D014656:Vascular Surgical Procedures / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Aneurysm, false/etiology; aortic insufficiency; endocarditis, bacterial/complications; sinus of Valsalva; streptococcal infections/ultrasonography