Healed perivalvular abscess: Incidental finding on transthoracic echocardiography.
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Date
2014-04
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Abstract
A 36‑year‑old male patient presented with the complaints of palpitations and breathlessness. Preoperative
transthoracic echocardiography (TTE) revealed a bicuspid aortic valve; severe aortic regurgitation with dilated
left ventricle (LV) and mild LV systolic dysfunction (ejection fraction 50%). He was scheduled to undergo
aortic valve replacement. History was not suggestive of infective endocarditis (IE). Preoperative TTE did
not demonstrate any aortic perivalvular abscess. Intraoperative transesophageal echocardiography (TEE)
examination using the mid‑esophageal (ME) long‑axis view, showed an abscess cavity affecting the aortic
valve, which initially was assumed to be a dissection flap, but later confirmed to be an abscess cavity by
color Doppler examination. The ME aortic valve short‑axis view showed two abscesses; one was at the
junction of the non‑coronary and left coronary commissure and the other one above the right coronary
cusp. Intraoperatively, these findings were confirmed by the surgeons. The case report demonstrates the
superiority of TEE over TTE in diagnosing perivalvular abscesses.
Description
Keywords
Aortic valve replacement, Infective endocarditis, Perivalvular abscess, Transesophageal echocardiography, Transthoracic echocardiography
Citation
Datt Vishnu, Diwakar Anitha, Malik Indra, Geelani M A, Tomar A S, Virmani Sanjula. Healed perivalvular abscess: Incidental finding on transthoracic echocardiography. Annals of Cardiac Anaesthesia. 2014 Apr; 17(2): 141-144.