scholarly journals Myocardial Infarction and Aortic Root Mycotic Aneurysm Complicating Aortic Valve Endocarditis: Utility of Cardiac CT

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Aimee E. Moores ◽  
Michael S. Cahill ◽  
Todd C. Villines
Keyword(s):  
Myocardial Infarction ◽  
Infective Endocarditis ◽  
Aortic Root ◽  
Mycotic Aneurysm ◽  
Imaging Modality ◽  
Invasive Coronary Angiography ◽  
Vascular Wall ◽  
Cardiac Cta ◽  
Life Threatening ◽  
Mycotic Aneurysms

Aortic mycotic aneurysms are a rare but life-threatening potential complication of infective endocarditis. Rapid deterioration of the vascular wall in highly focal areas makes these pseudoaneurysms particularly prone to rupture, resulting in uncontrolled aortic hemorrhage. While computed tomography angiography (CTA) is the imaging modality of choice for the evaluation of mycotic aneurysms, it is not routinely performed in patients with known or suspected infective endocarditis (IE). However, current valvular heart disease guidelines support the use of cardiac CTA in cases of IE and suspected perivalvular extension when there is inadequate or ambiguous visualization on echocardiography. Here, we describe a case of IE in which cardiac CTA was used for two purposes: to assess perivalvular complications and to define coronary anatomy in a patient with a suspected embolic myocardial infarction. Subsequent detection of an aortic root mycotic aneurysm not previously demonstrated on transthoracic or transesophageal echocardiography allowed for timely and uncomplicated surgical intervention, while avoiding invasive coronary angiography.

scholarly journals Screening for coronary artery disease in early surgical treatment of acute aortic valve infective endocarditis

2020 ◽  
Author(s):  
Wiebe G Knol ◽  
Ali R Wahadat ◽  
Jolien W Roos-Hesselink ◽  
Nicolas M Van Mieghem ◽  
Wilco Tanis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Infective Endocarditis ◽  
Perioperative Complications ◽  
Invasive Coronary Angiography ◽  
Perioperative Myocardial Infarction ◽  
Non Invasive ◽  
Estimated Risk ◽  
Artery Disease

Abstract OBJECTIVES In patients with unknown coronary status undergoing surgery for acute infective endocarditis (IE), the need to screen for coronary artery disease (CAD) and the risk of embolization during invasive coronary angiography (ICA) are debated. Coronary computed tomography angiography (CCTA) is a non-invasive alternative in these patients. We aimed to evaluate the safety and feasibility of ICA and CCTA to diagnose CAD, and the necessity to treat CAD to prevent CAD-related postoperative complications. METHODS In this single-centre retrospective cohort study, all patients with acute aortic IE between 2009 and 2019 undergoing surgery were selected. Outcomes were any clinically evident embolization after preoperative ICA, in-hospital mortality, perioperative myocardial infarction or unplanned revascularization and postoperative renal function. RESULTS Of the 159 included patients, CAD status was already known in 14. No preoperative diagnostics for CAD was done in 46/145, a CCTA was performed in 54/145 patients and an ICA in 52/145 patients. Significant CAD was found after CCTA in 22% and after ICA in 21% of patients. In 1 of the 52 (2%) patients undergoing preoperative ICA, a cerebral embolism occurred. The rate of perioperative myocardial infarction or unplanned revascularization in patients not screened for CAD was 2% (1 out of 46 patients). CONCLUSIONS Although the risk of embolism after preoperative ICA is low, it should be carefully weighed against the estimated risk of CAD-related perioperative complications. CCTA can serve as a gatekeeper for ICA in most patients with acute aortic IE.

scholarly journals Multiple Mycotic Aneurysms of the Abdominal Aorta Illustrated on MDCT Scanner

2015 ◽  
Vol 5 ◽  
pp. 49 ◽  
Author(s):  
Amit Nandan Dhar Dwivedi ◽  
Ananthakrishnan Srinivasan ◽  
Shivi Jain
Keyword(s):  
Early Detection ◽  
Abdominal Aorta ◽  
Mycotic Aneurysm ◽  
Abdominal Mass ◽  
Young Male ◽  
Aortic Aneurysms ◽  
Rare Manifestation ◽  
Life Threatening ◽  
Mycotic Aneurysms ◽  
Mdct Scanner

Infective mycotic aneurysm of the aorta is a rare and life-threatening disease. A patient presenting with constitutional symptoms and pulsatile abdominal mass should raise a suspicion of mycotic aneurysm. Early detection of aortic mycotic lesions in such patients should play a key role in the treatment of aortic aneurysms. Multiple mycotic aneurysms of abdominal aorta in a young male are a rare manifestation of the disease. Multidetector computerized tomography (CT) is an essential tool in identifying the etiology, pathogenesis, protean manifestations of systemic tuberculosis, and ultimately deciding the course of treatment.

A rare cause of chest pain in paediatric age: a teenager with acute myocardial infarction due to spontaneous coronary artery dissection

2022 ◽  
Vol 15 (1) ◽  
pp. e246393
Author(s):  
Filipa Costa Cascais ◽  
Ana Rita Pereira ◽  
Ana Rita Almeida ◽  
Luísa Rocha
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Coronary Artery ◽  
Invasive Coronary Angiography ◽  
Warning Signs ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Coronary Artery Dissection ◽  
Paediatric Age ◽  
Life Threatening

A healthy 17-year-old boy was admitted to the emergency department presenting with a pressure-like sternal pain that started during exercise. His physical examination was normal. Twelve-lead ECG and transthoracic echocardiogram suggested a myocardial infarction. The patient was submitted to an invasive coronary angiography, which revealed a distal occlusion of the left anterior descending artery, due to a spontaneous coronary artery dissection. A balloon angioplasty was performed, with good results. Aetiological study did not discover any pathologic condition. Chest pain in paediatric age is a frequent complaint, despite not being usually caused by a serious condition. However, it is important to remember warning signs in order to diagnose life-threatening diseases, as soon as possible.

scholarly journals Ruptured Intracranial Mycotic Aneurysm in Infective Endocarditis: A Natural History

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Isabel Kuo ◽  
Theodore Long ◽  
Nathan Nguyen ◽  
Bharat Chaudry ◽  
Michael Karp ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Natural History ◽  
Intracranial Aneurysms ◽  
Mycotic Aneurysm ◽  
Treatment Modalities ◽  
Intraparenchymal Hemorrhage ◽  
Retrospective Case ◽  
Aneurysm Clipping ◽  
History Of ◽  
Mycotic Aneurysms

Mycotic aneurysms are a rare cause of intracranial aneurysms that develop in the presence of infections such as infective endocarditis. They account for a small percentage of all intracranial aneurysms and carry a high-mortality rate when ruptured. The authors report a case of a 54-year-old man who presented with infective endocarditis of the mitral valve and acute stroke. He subsequently developed subarachnoid hemorrhage during antibiotic treatment, and a large intracranial aneurysm was discovered on CT Angiography. His lesion quickly progressed into an intraparenchymal hemorrhage, requiring emergent craniotomy and aneurysm clipping. Current recommendations on the management of intracranial Mycotic Aneurysms are based on few retrospective case studies. The natural history of the patient's ruptured aneurysm is presented, as well as a literature review on the management and available treatment modalities.

scholarly journals Trying to Survive A Serious Heart Condition in Time of COVID-19

2021 ◽  
Vol 24 (2) ◽  
pp. E372-E374
Author(s):  
Josip Varvodic ◽  
Verica Mikecin ◽  
Irzal Hadzibegovic ◽  
Marko Kutlesa ◽  
Carla Coric ◽  
...  
Keyword(s):  
Heart Failure ◽  
Infective Endocarditis ◽  
Aortic Root ◽  
The Past ◽  
Cardiac Decompensation ◽  
The World ◽  
Life Threatening ◽  
Emergent Surgery ◽  
Large Abscess ◽  
Heart Condition

The world has suffered over the past year under COVID-19. Unfortunately, people still are getting sick from other, also severe, diseases. Although the COVID-19 infection is present, patients need treatment for other life-threatening conditions. We present the case of a 36-year-old patient with severe infective endocarditis with a large abscess of the aortic root, who also is COVID-19 positive. Definitive diagnostics and treatment were avoided due to COVID-19 infection. In the end, emergent surgery was indicated due to acute cardiac decompensation and the development of heart failure symptoms, and the patient recovered uneventfully after surgery.

Endovascular Therapy for Distal Superior Mesenteric Artery Mycotic Aneurysms due to Infective Endocarditis

2019 ◽  
Vol 26 (6) ◽  
pp. 879-884
Author(s):  
Wataru Higashiura ◽  
Hiroaki Takara ◽  
Ryoichi Kitamura ◽  
Tomotaka Iraha ◽  
Akio Nakasu ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Superior Mesenteric Artery ◽  
Transcatheter Arterial Embolization ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Transarterial Embolization ◽  
Arterial Embolization ◽  
Collateral Flow ◽  
Ileocolic Artery ◽  
Mycotic Aneurysms

Purpose: To report 3 patients with infective endocarditis who underwent transcatheter arterial embolization for mycotic aneurysm of the distal superior mesenteric artery (SMA). Case Report: Three men (60, 64, and 65 years old) were diagnosed with infective endocarditis. Antibiotics were initiated immediately after admission and continued for several weeks to months. Distal SMA mycotic aneurysm was identified on computed tomography in the vicinity of the ileocolic artery at 33, 26, and 30 days after admission. In case 1, the ileal artery was occluded distal to the aneurysm, with collateral flow to the ileum. In case 2, the mycotic aneurysm was located below the ileocolic artery, which was stenosed distal to the lesion. In case 3, the aneurysm was located on a branch of the ileal artery. Transarterial embolization using microcoils was successfully performed in all patients. No complications associated with embolotherapy or relapse of infection were observed in these 3 patients at 60, 30, and 15 months, respectively. Conclusion: Transcatheter arterial embolization for distal SMA mycotic aneurysm could provide an alternative to open surgery. Anatomical assessment of collateral flow and preprocedure long-term antibiotic therapy could play important roles in preventing bowel ischemia and minimizing the risk of infection relapse.

scholarly journals Diagnosis and management of coronary artery disease in early surgical treatment of acute infective endocarditis of the aortic valve

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W.G Knol ◽  
A.W Wahadat ◽  
J.W Roos-Hesselink ◽  
W Tanis ◽  
A Hirsch ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Perioperative Complications ◽  
Invasive Coronary Angiography ◽  
Perioperative Myocardial Infarction ◽  
Asymptomatic Patients ◽  
Artery Disease

Abstract Background The need to routinely screen for coronary artery disease (CAD) in asymptomatic patients undergoing surgery for acute aortic valve infective endocarditis (IE) is debated. There is concern about the risk of embolization during invasive coronary angiography (ICA), especially in patients with vegetations. Coronary computed tomography angiography (cCTA) is a non-invasive alternative. Purpose To evaluate the prevalence of CAD in patients with acute aortic valve IE, the safety and feasibility of ICA and cCTA for diagnosis of CAD, and CAD related postoperative outcomes. Methods In this single center retrospective cohort study, all patients with acute infective aortic valve endocarditis between 2009–2019 undergoing surgery were selected. Outcomes were embolization after preoperative ICA, in-hospital mortality, perioperative myocardial infarction or unplanned revascularization. Results 159 patients (mean age 58±15, 81% male) underwent surgery. No CAD screening was done in 46/145, a cCTA was performed in 54/145 patients and an ICA in 52/145 patients. In 1 of the 52 patients undergoing preoperative ICA a cerebral embolism occurred. cCTA was not assessable on a patient level in 2 patients and 7 patients underwent both cCTA and ICA. Significant CAD was found in about 20% of patients both after cCTA and ICA. Even though just a minority of patients with CAD was treated with concomitant CABG, only 1 patient with known but untreated CAD needed unplanned revascularization postoperatively. The rate of perioperative myocardial infarction or unplanned revascularization in patients not screened for CAD was 5% (3 patients). Conclusion In patients with acute aortic valve IE the prevalence of CAD is low (14%). The risk of embolism after preoperative ICA is not negligible and should be carefully weighed against the estimated risk of CAD-related perioperative complications. cCTA might serve as a gatekeeper for ICA in many patients with acute aortic IE. Funding Acknowledgement Type of funding source: None

scholarly journals Infective Endocarditis with Multiple Mycotic Aneurysms Mimicking Vasculitis: A Case Report

2012 ◽  
Vol 23 (3) ◽  
pp. e67-e68 ◽  
Author(s):  
Ji Hyeon Park ◽  
Hye Ryoun Jang ◽  
Jung Eun Lee ◽  
Wooseong Huh ◽  
Dae Joong Kim ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mycotic Aneurysm ◽  
Skin Lesions ◽  
Neurological Complications ◽  
Blood Cultures ◽  
Renal Infarction ◽  
Viridans Streptococci ◽  
Mycotic Aneurysms ◽  
Mitral Valve Vegetation

The manifestation of infective endocarditis often resembles vasculitis. Approximately one in five infective endocarditis cases are referred initially to a nephrologist because of abnormal renal function or abnormal urinalysis; therefore, infection should be ruled out before diagnosing vasculitis.A case involving a patient with infective endocarditis who presented with migrating skin lesions, renal infarction and multiple pseudoaneurysms is reported. Echocardiography revealed mitral valve vegetation and viridans streptococci were identified in peripheral blood cultures. Although mitral valve annuloplasty and an aneurysm ligation operation were performed with proper antibiotic treatment, the remaining mycotic aneurysm progressed and caused neurological complications. The patient was cured completely after reoperation.

Sign in / Sign up

Export Citation Format

Share Document