Aorto-cavitary fistula to the left ventricle with severe aortic regurgitation as a complication of prosthetic valve infective endocarditis: a novel report

Author:

Sanchez-Nadales Alejandro1ORCID,Celis-Barreto Valentina2,Khan Amir1,Anampa-Guzman Andrea3ORCID,Olanipekun Olalekan1

Affiliation:

1. Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA

2. Department of Medicine, Mount Sinai Medical Center of Florida, Miami Beach, FL, USA

3. Faculty of Medicine, Sociedad Cientifica de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru

Abstract

ABSTRACT Infective endocarditis can present in different clinical forms and lead to a variety of complications depending on the affected valvular and perivalvular structures. We describe a case of a 74-year-old male who developed an aortic-cavitary fistulous tract as a complication of prosthetic aortic valve infective endocarditis. Transesophageal echocardiography (TEE) revealed an aorto-cavitary fistula (ACF) connecting the aortic root with the left ventricle, creating an intracardiac shunt, which resulted in severe aortic regurgitation physiology. The patient underwent surgery with successful exclusion of the ACF. ACF is an unusual complication of infective endocarditis that creates an abnormal communication between the aortic root and the heart chambers, establishing an intracardiac shunt. This case highlights that physicians should be aware of the possibility of rare cardiac complications in infective endocarditis. TEE is a valid diagnostic test for ACF.

Publisher

Oxford University Press (OUP)

Subject

Cell Biology,Developmental Biology,Embryology,Anatomy

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