Delayed Infective Endocarditis with Mycotic Aneurysm Rupture below the Mechanical Valved Conduit after the Bentall Procedure.
The Bentall procedure is the gold standard for treating aortic dissection complicated with valvular and ascending aorta disease. Recent results for this procedure have been excellent; nearly 100% of patients remain free of infective endocarditis in long-term follow-up. We report a case of delayed Streptococcus agalactiae infective endocarditis complicated by mycotic aneurysm in a man who had undergone the Bentall procedure with a mechanical valve conduit 15 years previously. The mycotic aneurysm was located in the remnant aortic root, below the mechanical valve conduit, and later ruptured into the right atrium. The patient was treated conservatively and survived the acute period. Later, the aortic root defect was repaired successfully by means of a hybrid technique using a Amplatzer duct occluder.


BACKGROUND
Amplatzer duct occluder; Aortic dissection; Bentall technique; Infective endocarditis; Mycotic aneurysm.
Department of Internal Medicine; ; Buddhist Tzu Chi University, Hualien;
Mei-Ling
ML
Chen
Department of Cardiology, Buddhist Tzu Chi General Hospital; ; Buddhist Tzu Chi University, Hualien;
Michael Y
MY
Chen
Heart Center, Cheng Hsin General Hospital; ; Faculty of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan.
Wei-Hsian
WH
Yin
Heart Center, Cheng Hsin General Hospital;
Jeng
J
Wei
Department of Cardiology, Buddhist Tzu Chi General Hospital; ; Buddhist Tzu Chi University, Hualien;
Ji-Hung
JH
Wang