title: Infective endocarditis of an aorto-right atrial fistula caused by asymptomatic rupture of a sinus of Valsalva aneurysm: a case report.
abstract: Asymptomatic rupture of a sinus of Valsalva aneurysm is rare. A fistula following rupture of a sinus of Valsalva aneurysm may cause infective endocarditis. Here, we report a case of infective endocarditis of an aorto-right atrial fistula caused by asymptomatic rupture of a sinus of Valsalva aneurysm. A 45-year-old male, who was first diagnosed with a heart murmur at the age of 37 years, presented with fever. Blood culture was positive for Streptococcus gordonii. Ultrasound echocardiography revealed an aorto-right atrial fistula caused by rupture of a sinus of Valsalva aneurysm. After the infective endocarditis was healed by antibiotics, we successfully performed surgical repair of the aorto-right atrial fistula. Although asymptomatic rupture of a sinus of Valsalva aneurysm is uncommon, it should be recognized as a possible cause of infective endocarditis.
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan. ai-cvs@sd6.so-net.ne.jp.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikeda
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nakajima
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Konishi
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Matsuzaki
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Sugano
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Fumikura
authors.affiliation: Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishina
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Jikuya
keywords: Aorto-right atrial fistula; Infective endocarditis; Sinus of Valsalva aneurysm