A postoperative left ventricular-right atrial shunt due to infectious endocarditis after aortic repair with aortic valve replacement detected by transesophageal echocardiography
Tóm tắt
Infectious endocarditis (IE) with acute heart failure is a medical emergency. In particular, postoperative IE after aortic repair with an artificial vascular graft is a life-threatening matter. We present a case in which a mobile abscess appeared on the aortic valve annulus with an intra-cardiac shunt in the left ventricle (LV) to the right atrium (RA) after ascending aortic repair with aortic valve replacement (AVR) for acute type A aortic dissection. It was diagnosed with transesophageal echocardiography (TEE), which prompted further exploration.
Tài liệu tham khảo
Gerbode F, Hultgren H, Obsborn J. Syndrome of left ventricular-right atrial shunt: successful surgical repair of defect in five cases, with observation of bradycardia on closure. Ann Surg. 1958;148:433–46.
Sabik JF, Lytle BW, Bkackstone EH, Marullo AG, Pettersson GB, Cosgrove DM. Aortic root replacement with cryopreserved allograft for prosthetic valve endocarditis. Ann Thorac Surg. 2002;74:650–9.
Stechert MM, London MJ. Native aortic root endocarditis with invasion of the right outflow tract. Anesth Analg. 2010;110:36–8.
Silverman NA, Sethi GK, Scott SM. Acquired left ventricular-right atrial fistula following aortic valve replacement. Ann Thorac Surg. 1980;30:482–6.
Walmsley R, Watson H. The medial wall of the right atrium. Circulation. 1966;3:400–11.
Karalis DG, Bansal RC, Hauck AJ, Ross Jr JJ, Applegate PM, Jutzy KR, Mintz GS, Chandrasekaran K. Transesophageal echocardiographic recognition of subaortic complications in aortic valve endocarditis. Clinical and surgical implications. Circulation. 1992;86:353–62.
Stechert MM, Kellermeier JP. Aorto-atrial fistula: an important complication of aortic prosthetic valve endocarditis. Anesth Analg. 2007;105:332–3.