EPIDEMIOLOGY Predisposing factors for infective endocarditis are cardiac abnormalities that disrupt the endocardium by means of a jet injury, as well as the presence of blood-borne microorganisms that colonize these abnormal surfaces. Congenitally bicuspid aortic valve is the most common predisposing lesion for endocarditis of the aortic valve. In addition, congenital abnormalities of the aorti...

OBJECTIVE To assess the long term prognostic significance of aortic valve ring abscess in patients with aortic endocarditis. PATIENTS A consecutive series of 75 patients who had surgery for aortic infective endocarditis between 1981 and 1989; 35 had aortic ring abscesses (group 1) and 40 did not (group 2). Mean age did not differ between the two groups. Prosthetic valve endocarditis was prese...

Prosthetic aortic valve replacement for aortic valve endocarditis remains a primary practice of most cardiac surgeons. Usually it cures endocarditis and restores cardiac function. However, in advanced aortic valve endocarditis with complex annular destruction, complications following prosthetic aortic valve replacement do occur and present a formidable challenge for reoperation. Herein, we desc...

A 28-year-old man with infective endocarditis of the aortic valve underwent a course of antibiotic therapy, but developed severe aortic root deformity requiring aortic root replacement with a mechanical composite valve conduit. Of note, this patient had undergone a previous aortic valve operation for bicuspid valve stenosis, and indurations and fragility of the aortic root caused by the precedi...

To the Editor: I read with interest the contribution by Cai et al in the “Images in Cardiovascular Medicine” section of the journal.1 They described a patient who developed severe aortic regurgitation and a mitral valve aneurysm 1 month after successful treatment of Streptococcus mitis endocarditis. The case presentation and the title implied that the mitral valve aneurysm was caused by the eff...

Paravalvular abscess is a serious complication of infective endocarditis. The aortic valve and its adjacent ring are more susceptible to abscess formation and paravalvular extension than the mitral valve. A 15-years old patient with bicuspid aortic valve presented with staphylococcal tricuspid valve endocarditis complicated by para-aortic abscess that ruptured into the aortic sinus. We report t...

Aortocardiac fistulae (ACF) are exceptionally due to infective endocarditis; they are usually congenital, posttraumatic, or complicate aortic dissection. In infective endocarditis setting, their presence should prompt urgent surgery as patients can deteriorate rapidly. We report the case of a 78-year-old female patient with the first ever reported quadricuspid aortic valve infective endocarditi...

Identifying the pathogen responsible for culture-negative valve endocarditis often depends on molecular studies performed on surgical specimens. A patient with Ehlers-Danlos syndrome who had an aortic graft, a mechanical aortic valve, and a mitral anulloplasty ring presented with culture-negative prosthetic valve endocarditis and aortic graft infection. Research-based polymerase chain reaction ...

The diagnosis of aortic ring abscess by cross-sectional echocardiography has not been reported. In this paper, a case of bacterial endocarditis of the aortic valve extending to the aortic ring and the mitral valve is reported. The role of cross-sectional echocardiography in defining the anatomic distortion of the aortic valve in bacterial endocarditis and its complications is emphasized. This s...

PURPOSE It has been reported that surgical treatment for prosthetic valve endocarditis complicated by destruction of the aortic annulus is associated with high mortality and morbidity. The aim of this study was to evaluate the efficacy of our surgical strategy for this situation. METHODS Between October 2003 and April 2009, eight patients (mean age 68.6 years) with prosthetic valve endocardit...