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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infective aneurysm showing dilatation of all three coronary sinuses of Valsalva due to infective endocarditis is extremely rare. We present the first report of such a case complicated by left single coronary artery. The patient was a 55-year-old man with a past history of untreated diabetes mellitus, cerebral infarction, aortic regurgitation and high-grade fever. He was admitted with a complaint of easy fatigability. In a treadmill exercise test, asymptomatic ischemic depression of the ST segment was observed. Two-dimensional echocardiography revealed marked dilatation of all three sinuses of Valsalva, and a mural thrombus within the dilated right sinus of Valsalva. On magnetic resonance imaging, an abnormal signal in the markedly dilated right sinus of Valsalva was revealed. Coronary arteriography showed left single coronary artery (L1 type by Sharbaugh's classification). The histopathological features of the affected aorta were thought to represent the healing stage of infective endocarditis. With regard to the myocardial ischemia in this patient, it was thought to have arisen mainly through aortic regurgitation and coronary atherosclerosis due to single coronary artery, and partly influenced by untreated diabetes mellitus.
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PMID:A rare case of infective aneurysm involving all three sinuses of Valsalva complicated by left single coronary artery. 202 86

A 56-year-old man, who had been febrile for one month, suddenly had severe left foot pain. He also became dyspneic. Embolic occlusion of left femoral artery as well as severe acute aortic regurgitation due to Staphylococcus endocarditis was demonstrated by arteriography and echocardiography. The patient underwent emergency aortic valve replacement and above knee amputation of left foot at the same time. Postoperatively he continued to be hypotensive and, at 6th postoperative day, abdominal vascular bruit was first observed. Aortography revealed left common iliac aneurysm with an arterio-venous fistula. The aneurysm was excised and venous opening of the fistula was oversewn. Aortic end was reconstructed with bifurcated prosthetic graft. Antibiotic therapy was continued 6 weeks. His postoperative course was uneventful.
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PMID:[Successful management of mycotic abdominal arteriovenous fistula complicated with infective endocarditis--a case report]. 202 6

Fifty cases of aortic valve endocarditis during a 6-year period between 1982 and 1988 were reviewed. Twenty-three (46%) had aortic root complications by way of aortic root abscess or mycotic aneurysm in the perivalvular area. Patients with root complications were grouped into the aortic root abscess (ARA) group and those without into a non root abscess (NARA) group. Prosthetic valve endocarditis dominated in the ARA group (12 and four cases of prosthetic valve infection in the ARA and NARA groups, respectively; P less than 0.01). Surgical mortality was significantly higher at 13.6% in the ARA group as opposed to 2.2% in the NARA group (P less than 0.05). Post-operative aortic regurgitation was present in 8 (57%) of 14 patients in the ARA group surviving surgery but in only two (8.7%) of 23 patients in the NARA group (P less than 0.03). We conclude that aortic root complications are a frequent occurrence in aortic valve endocarditis, lead to an increased operative mortality and is associated with a high incidence of post-operative aortic regurgitation.
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PMID:Aortic root complications of infective endocarditis--influence on surgical outcome. 204 59

We experienced a case of pulmonary sequestration of Pryce type I associated with infective endocarditis (IE). A 19-old-man had prolonged high fever of 39 degrees C against antibiotic therapy. He was referred to our hospital because of the positive blood culture and abnormal echocardiographic findings, which were severe aortic regurgitation with vegetations clinging the aortic cusps. In addition, his chest X-ray film showed mass lesion behind the cardiac shadow, and continuous murmur was auscultated on this portion. The left pulmonary arteriography revealed no arterial distribution to the left lower lobe, while aortography showed an aberrant artery arising from the descending aorta entering into this lobe. One month after aortic valve replacement for IE, left lower lobectomy and amputation of the aberrant artery were performed successfully. Pathologically, inflammatory changes of the aortic valve and proliferations of intimal and medial wall of the aberrant artery were shown. However, alveo-bronchial structure of the resected lobe was normal. Diagnosis, complications and surgical management of pulmonary sequestration were discussed.
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PMID:[A case report of pulmonary sequestration (Pryce I) associated with infective endocarditis]. 205 Nov 13

Management considerations for dealing with a patient with acute regurgitation of the aortic valve have been emphasized. Recognition and treatment of the most usual causes of acute aortic regurgitation have been described and the emphasis placed on early surgical treatment in the appropriate patient. In particular, management strategies for acute infective endocarditis and acute aortic dissection must be done on a timely basis. Operative intervention earlier rather than later generally improves results and prevents the long-term complications of delayed operations in anatomically complex patients. Whereas accurate preoperative diagnosis and attempts in medical treatment are mandatory before embarking on surgical therapy, the best results are achieved when definitive repair is performed early in the patient's course. Failure to do so inevitably leads to complications that only worsen the ultimate outcome in terms of morbidity and mortality.
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PMID:Therapy of acute aortic regurgitation. 205 22

Since it is very rare that cardiac tamponade due to myocardial rupture caused by infective endocarditis, occurs we are reporting this case. A 62 year old man, who had underlying diseases of pneumoconiosis and hypertensive heart disease, visited Chikuho Rosai Hospital complaining of chest oppression and general fatigue on Feb. 7, 1987. He was diagnosed as having ischemic heart disease by electrocardiogram. Two days later, he suddenly had chills and a fever, and the laboratory data showed leukocytosis and a positive C-reactive protein (CRP). The echo cardiogram showed mitral regurgitation (MR) and aortic regurgitation (AR), but neither vegetation nor pericardial effusion was observed. On Feb. 16, he was admitted with shock, and he died the next day. The blood cultures grew gram-positive cocci, respectively. From the clinical symptoms, chest roentgenogram and electrocardiogram, we suspected a cardiac tamponade. On autopsy findings, though coronary arteries were intact, the aortic valves had severe valvular adhesions, calcifications and hypertrophies. The rupture hole was observed in the left ventricles, which was just under the aortic valve through the pericardiac space. It seemed that he died of a cardiac tamponade due to the outflow of blood from this hole. On histopathologic findings of the cardiac wall, gram-positive cocci and many of neutrophils were observed.
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PMID:[An autopsied case of infective endocarditis with cardiac tamponade due to myocardial rupture]. 207 73

The authors studies 154 cases of degenerative aortic regurgitation which presented macroscopically with atrophic changes of the valve and sometimes with hypertrophy and calcification. Histologically, the essential abnormality was the finding of mucopolysaccharide deposits dissociating the corpus spongiosa from the corpus fibrosa. Depending on the importance of these lesions, three degrees of severity can be defined, the most extensive (84% of our patient population) appearing to be typical of the disease. In addition, mild mitral valve prolapse (5%) and medial necrosis of the aortic wall (80% of patients undergoing aortic biopsy) were observed. These morphological features are on the whole quite different to those of other aortic valve pathologies (rheumatic, endocarditis). However, the border line with other pathologies with a similar anatomopathological substratum is less clearly defined: genetic abnormalities (Marfan's syndrome, Lobstein's disease, etc...) or age-related degenerative disease. The pathogenesis is not clearly understood but could be related to regional disturbances in collagen metabolism with collagenolysis predominating.
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PMID:[Pathology of degenerative aortic valve insufficiency]. 211 52

The authors report the value of Doppler color flow mapping in the diagnosis of late diastolic mitral regurgitation in two patients with severe post-endocarditis aortic regurgitation requiring rapid surgical intervention. Doppler color flow mapping played an essential part in the management of these cases by helping in the diagnosis of late diastolic mitral regurgitation which is known to carry a very poor prognosis in this context.
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PMID:[Value of Doppler color echocardiography in the diagnosis of diastolic mitral insufficiency in severe aortic insufficiency. Report of 2 cases]. 212 22

Septic arthritis developed in a neonate after an infection of her hand. Despite medical and surgical treatment endocarditis of her aortic valve developed and the resultant regurgitation required emergency surgery. At operation a new valve cusp was fashioned from preserved calf pericardium. Nine years later she was well and had full exercise tolerance with minimal aortic regurgitation.
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PMID:Replacement of an aortic valve cusp after neonatal endocarditis. 220 13

A case in which rupture of a hepatic artery aneurysm occurred 4 months after aortic valve replacement because of aortic regurgitation due to infective endocarditis (IE) is reported. The patient was a 41-year-old male who underwent aortic valve replacement and closure of an abscess cavity of the Valsalva's sinus because of aortic regurgitation and an abscess of the Valsalva's sinus complicated with active IE. His postoperative course was good with no fever. Four months postoperatively, rupture of an aneurysm of the left intrahepatic artery occurred suddenly, and the patient's life was saved by resection of the lateral segment of the left lobe of the liver. Histologically, the wall structure of the aneurysm was not preserved, infiltration of neutrophils was seen in part of the wall, and a mycotic aneurysm of the left hepatic artery within the liver cause by IE was diagnosed. In Japan, only four cases, including the present one, of mycotic aneurysm of the hepatic artery have been reported in the literature examined, and this was the first case in which the patient's life as saved after a rupture. It is essential when observing the course of IE patients to bear in mind at all times that such a complication might occur.
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PMID:[Report of a case which survived rupture in a hepatic artery mycotic aneurysm after aortic valve replacement]. 221 91


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