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Alfieri M, Ianni U, Molisana M, Parato VM. There is Nothing More Invisible than the Obvious: A Case Summary and Literature Review. J Cardiovasc Echogr 2023; 33:195-198. [PMID: 38486694 PMCID: PMC10936702 DOI: 10.4103/jcecho.jcecho_50_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/22/2023] [Indexed: 03/17/2024] Open
Abstract
Bioprosthetic valvular failure (BVF) is a pathological entity arising from a variety of conditions affecting prosthetic heart valves. It may present with an extremely varied pattern, and the identification of the exact etiology is vital to provide a prompt and adequate treatment. It is established that infective endocarditis mainly affects patients with intracardiac devices such as pacemakers or prosthetic valves, and it represents one of the principal mechanisms of BVF. Despite its high incidence, clinical presentations may be atypical, and a close monitoring is essential to prevent catastrophic consequences. We present the case of a partial valvular bioprosthesis detachment associated with a newly formed pseudoaneurysm due to a late infective endocarditis occurred after cardiac surgery, initially manifested with negative blood cultures and clinical findings. We also try to set up a literature review of the most common causes of valvular failure and pseudoaneurysm formation.
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Affiliation(s)
- Michele Alfieri
- Cardiology and Arrhythmology Clinic, Department of Cardiovascular Sciences, University Hospital “Ospedali Riuniti”, Ancona, Italy
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
| | - Umberto Ianni
- Department of Biomedical Sciences and Public Health, Cardiology and Cardiac Rehabilitation Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Michela Molisana
- Department of Biomedical Sciences and Public Health, Cardiology and Cardiac Rehabilitation Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
| | - Vito Maurizio Parato
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy
- Department of Biomedical Sciences and Public Health, Cardiology and Cardiac Rehabilitation Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy
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Ching S, Yue CS. Sinus of Valsalva Pseudoaneurysm Complicating Infective Endocarditis Causing Right Ventricular Inflow Obstruction. J Cardiovasc Echogr 2023; 33:33-35. [PMID: 37426721 PMCID: PMC10328123 DOI: 10.4103/jcecho.jcecho_64_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 02/06/2023] [Accepted: 03/16/2023] [Indexed: 07/11/2023] Open
Abstract
Sinus of Valsalva pseudoaneurysm (SVpA) is a rare cause of right ventricular inflow obstruction. We report such a case presented with atrial flutter and cardiogenic shock caused by tricuspid valve obstruction by a narrow-necked right SVpA complicating aortic valve infective endocarditis demonstrated on transesophageal echocardiography and cardiac computed tomography. Despite restoration of sinus rhythm, the patient ran a fatal course due to aneurysmal rupture. We show the value of transesophageal echocardiography in evaluating unstable patients with cardiogenic shock, and the need of urgent surgery in selected patients to avoid a dismal outcome.
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Affiliation(s)
- Shing Ching
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China
| | - Chiu Sun Yue
- Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong, China
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Park HO, Byun JH, Moon SH, Kim JW, Kim SH, Kim KN, Jung JJ, Kang DH, Choi JY, Yang JH, Jang IS, Lee CE. A case report of pseudoaneurysm of left sinus of Valsalva invaded into the left ventricle with severe aortic regurgitation. J Cardiothorac Surg 2018; 13:63. [PMID: 29880022 PMCID: PMC5992747 DOI: 10.1186/s13019-018-0754-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 05/31/2018] [Indexed: 11/17/2022] Open
Abstract
Background The pseudoaneurysms of sinus of Valsalva is an uncommon and serious complication of an infection, trauma, or after cardiac surgery or procedure. Pseudoaneurysms of sinus of Valsalva from left is rare. We describe a case of pseudoaneurysm of the left coronary sinus of Valsalva invaded into the left ventricle (LV) diagnosed by transthoracic echocardiography (TTE), transesophageal ecoccardiography (TEE), and multiple detector computed tomography (MDCT). Case presentation A 44-year-old male patient had New York Heart Association (NYHA) class II / III dyspnea during 4 months. He underwent surgery including aortic valve replacement using mechanical prosthesis, and he was discharged well without significant complications on follow – up TTE and chest computed tomography (CT) post-operative 7 days. Conclusions We report this rare case in which a ruptured pseudoaneurysm of sinus of Valsalva into LV with severe AR due to perforation of LCC was successfully-treated.
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Affiliation(s)
- Hyun Oh Park
- Department of Thoracic and Cardiovascular Surgery, Jinju Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Joung Hun Byun
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea.
| | - Seong Ho Moon
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - Jong Woo Kim
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - Sung Hwan Kim
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - Ki Nyun Kim
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - Jae Jun Jung
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - Dong Hoon Kang
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - Jun Young Choi
- Department of Thoracic and Cardiovascular Surgery, Jinju Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Jun Ho Yang
- Department of Thoracic and Cardiovascular Surgery, Changwon Hospital, Gyeongsang National University College of Medicine, 11, Samjeongja-ro, Seongsan-gu, Changwon-si, 51472, Republic of Korea
| | - In Seok Jang
- Department of Thoracic and Cardiovascular Surgery, Jinju Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Chung Eun Lee
- Department of Thoracic and Cardiovascular Surgery, Jinju Hospital, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
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