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

53-year-old male was introduced our hospital for treatment of his infective endocarditis and congestive heart failure. Further evaluation revealed massive destruction of the mitral valve and aneurysm of the right coronary artery. We carried out an operation of aneurysmectomy and CABG with RGEA for coronary artery, and MVR using 29 mm SJM valve. Postoperative course was excellent. Graftgram showed good patency and perfusion of RGEA. Pathological findings were 1) macrophage infiltration into thrombi, 2) disappearance of elastic fibers of the media. 3) least atherosclerosis of the intima. We concluded that it was a mycotic coronary artery aneurysm. There have been no report of surgical treatment of such a mycotic coronary artery aneurysm upon our investigation.
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PMID:[Surgical treatment of mycotic coronary artery aneurysm associated with infective endocarditis: a case report]. 881 59

Coronary artery fistulae (CAF) are infrequent congenital anomalies. The combination of coronary artery aneurysms and coronary artery fistulae (coronary artery aneurysm associated with fistula, CAAAF) is extremely rare, and only 50 cases, including the current case, have been reported. Coronary artery fistulae may result in coronary ischemia, congestive heart failure, and endocarditis. Complications of coronary artery aneurysms include thrombosis, distal emboli, and aneurysm rupture. Aneurysm repair, fistulous closure and/or coronary artery bypass grafts are definite treatments for CAAAF. We present here a 72-year-old female with CAAAF. Furthermore, all reported CAAAF cases are reviewed.
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PMID:Coronary artery aneurysm associated with fistula in adults: collective review and a case report. 1050 53

Mycotic aneurysms are well-documented complications of infective endocarditis and occur frequently in the intracranial arteries. However, mycotic aneurysms of the coronary arteries are very rare, and there are few reports of the management of these lesions. The authors report the case of a 72-year-old woman with coagulase-negative staphylococcal endocarditis involving a perforated aortic valve, a perforated mitral valve aneurysm, and a large mycotic coronary artery aneurysm. After antimicrobial therapy, the patient underwent open-heart surgery with mitral and aortic valve replacement, coronary artery bypass, and resection of the mycotic coronary aneurysm. The authors present detailed serial echocardiograms of the mycotic coronary artery aneurysm, which was subsequently confirmed intraoperatively and pathologically.
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PMID:Infective endocarditis complicated by mycotic aneurysm of a coronary artery with a perforated mitral valvular aneurysm. 1926 81

We report a rare case of a 65-year-old woman who underwent an emergent lifesaving heart operation for an undiagnosed right coronary artery aneurysm with a coronary arteriovenous fistula complicated by active infective endocarditis, which affected the aortic valve, mitral valve, and coronary sinus. We performed direct closure of the coronary arteriovenous fistula, ligation of the right coronary artery aneurysm, double coronary artery bypass grafting, and double valvular replacement. Five years after the operation, she had no sign of congestive heart failure or infection, and was not receiving antibiotics.
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PMID:Successful repair for a giant coronary artery aneurysm with coronary arteriovenous fistula complicated by both right- and left-sided infective endocarditis. 1983 May 18

A 54-year-old man with infective tricuspid endocarditis and an infective right coronary artery aneurysm was scheduled for simultaneous coronary artery aneurysmectomy and tricuspid valvulectomy. However, the tricuspid valve replacement and annuloplasty procedures could not be performed because vegetation was noted on all his tricuspid leaflets. Moreover, the infective right coronary artery aneurysm was located proximal to the annulus of the tricuspid valve. Complications of tricuspid valvulectomy include tricuspid regurgitation, right ventricular capacity load and right ventricular pressure load. In the present case, after the patient was weaned from cardiopulmonary bypass (CPB), transesophageal echocardiography (TEE) revealed severe tricuspid regurgitation and shifting of the interventricular septum toward the left ventricle at the telediastolic stage. We managed this condition on the basis of the TEE findings with fluid therapy and a nitroglycerin vasoactive agonist, and adjusted the ventilator setting to reduce pulmonary vascular resistance. In the present case of infective tricuspid endocarditis with infective right coronary artery aneurysm, the selection of the appropriate surgical method was important. Moreover, respiratory management which did not increase pulmonary vascular resistance and adequate fluid management based on TEE findings after weaning from CPB were equally important during anesthesia for tricuspid valvulectomy.
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PMID:[Anesthesia management during coronary artery aneurysmectomy and tricuspid valvulectomy]. 2323 38

Pseudoaneurysm of mitral-aortic intervalvular fibrosa (MAIVF) is a rare complication associated with aortic and/or mitral valve surgery complicated by infective endocarditis. We report pseudoaneurysm of MAIVF in a young adult without overt cardiac disease or previous cardiac surgery. The patient had a rare combination of pseudoaneurysm of MAIVF impinging on anterior mitral leaflet causing moderate mitral regurgitation, right sinus of Valsalva aneurysm extending into interventricular septum, and left main coronary artery aneurysm. Transesophageal echocardiography helped in confirming the lesions, delineating the anatomy of all the lesions, and assessing the adequacy of surgical repair.
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PMID:Transesophageal echocardiography in surgical management of pseudoaneurysm of mitral-aortic intervalvular fibrosa with aneurysms of right sinus of Valsalva and left main coronary artery. 2328 84

Mycotic coronary aneurysm formation is a rare complication in patients with infective endocarditis. Furthermore, rupture of coronary artery aneurysm, also rare, is life threatening. Sudden rupture of left main mycotic coronary aneurysm occurred in a patient, aged 68 years, 1 month after root replacement for aortic regurgitation caused by infectious endocarditis. A polytetrafluoroethylene-covered stent was implanted covering the entire aneurysmal portion crossing over the left circumflex coronary artery in this emergent situation. After a successful hemostatic procedure, the patient recovered from cardiogenic shock. We confirmed the sustained patency of the stent segment by coronary angiography 6 months after the procedure.
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PMID:Successful endovascular treatment of rupture of mycotic left main coronary artery aneurysm. 2339 19

Coronary artery fistulae are uncommon but may be haemodynamically significant, being an incidental finding in 0.1-0.2% of coronary angiograms. Even rarer is the association between fistulae and non-atherosclerotic coronary artery aneurysms. They most frequently originate in the right coronary artery, and the right cardiac chambers are the most common draining chambers. Most children are asymptomatic, whereas those older than 20 years may present with signs of congestive heart failure, infective endocarditis, myocardial ischaemia, or aneurysm rupture. Management is either surgical or via percutaneous means. We report the case of a 5-year-old child referred for assessment of an asymptomatic cardiac murmur. The echocardiographic evaluation showed an enlarged right atrium, a fenestrated atrial septal defect, and a giant right coronary artery aneurysm with a fistulous tract that appeared to drain directly into the right atrium. Computed angiocardiac tomography and cardiac catherisation confirmed the presence of a large right coronary fistula originating from the right coronary aneurysm draining into the right atrium. The patient underwent surgical ligation of the fistula and the post-operative course has been uneventful. He is currently on double antiaggregation therapy.
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PMID:Accidental finding of a giant right coronary artery aneurysm associated with a fistula to the right atrium. 2369 44

Aneurysms of the coronary arteries are rare and are usually associated with atherosclerosis in adults. Mycotic coronary artery aneurysms are exceedingly uncommon and are typically associated with systemic bacteremia, endocarditis, or septic emboli. Literature and data describing the management of mycotic coronary artery aneurysms are limited. This case describes the successful diagnosis of a large right coronary artery aneurysm by transesophageal echocardiogram as well as the successful management of the aneurysm.
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PMID:The diagnosis and treatment of a mycotic coronary artery aneurysm: a case report. 2393 87

We describe the case of a 75-year-old man with a mycotic right coronary artery aneurysm without evidence of prosthetic valve endocarditis. Eight years previously he had undergone coronary artery bypass surgery and aortic valve replacement. He presented with methicillin resistant staphylococcus aureus septicaemia after a prolonged hospital admission. Further investigation revealed a large mycotic right coronary artery aneurysm prompting urgent surgical repair. This case, of a mycotic coronary artery aneurysm in an atherosclerotic native coronary artery, is an extremely rare entity, which is further complicated by the presence of a prosthetic aortic valve.
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PMID:Repair of a Mycotic Coronary Artery Aneurysm with an Intact Prosthetic Aortic Valve. 2647 46


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