Open AccessTriple leaflet perforation due to endocarditis in aortic valve complicated by pneumonia and exacerbation of chronic obstructive pulmonary disease
Author(s) -
Elton Soydan,
Cüneyt Narin,
İlker Kiriş
Publication year - 2015
Publication title -
international journal of the cardiovascular academy
Language(s) - English
Resource type - Journals
eISSN - 2618-6012
pISSN - 2405-8181
DOI - 10.1016/j.ijcac.2015.07.015
Subject(s) - medicine , cardiology , exacerbation , endocarditis , perforation , aortic valve , pulmonary disease , pneumonia , acute exacerbation of chronic obstructive pulmonary disease , infective endocarditis , leaflet (botany) , surgery , punching , materials science , metallurgy , paleontology , biology
Valve perforation complicating infective endocarditis has been for decades a bad sign leading to severe valve destruction, intractable heart failure and even death if surgical therapy is not administered in time. Here we present a 57 years old male patient inadvertently diagnosed with pneumonia and chronic obstructive pulmonary disease exacerbation in another hospital. After 20 days of broad spectrum antibiotics and bronchodilator therapy no improvement was achieved. During examination a severe aortic regurgitation was recognized. Immediately after, patient was transferred to our hospital for aortic valve surgery evaluation. Transthorasic echocardiography (TTE) showed a severe aortic regurgitation and vegetation like echogenicity over the noncoronary leaflet. An aortic valve replacement surgical therapy was decided. During the aortic valve excision underneath the vegetations, multiple small perforations in all the three leaflets were noticed. The destructed valve was excised and a mechanical aortic prosthesis (St Jude No: 23, MN, USA) was successfully replaced. After 14 days of treatment patient was healthily discharged