Abstract
Paravalvular aortic root abscess with intracardiac fistula formation is an exceedingly rare complication of infective endocarditis. This condition is even more rarely encountered in patients with bioprosthetic valve endocarditis. We report an unusual case of a 68-year-old Bosnian female with a bioprosthetic aortic valve, who developed an extensive aortic root abscess, complicated by an aortico-left atrial intracardiac fistula. This case illustrates that a high index of suspicion, prompt diagnosis by echocardiography, proper antibiotic therapy, and early surgical intervention are crucial to improving treatment outcomes for this rare condition.
Highlights
The spread of infective endocarditis from valvular structures to surrounding tissues results in periannular complications that may place patients at increased risk for adverse outcomes, including congestive heart failure, heart block, and death
The incidence of this complication is estimated at 1-2% of all cases of infective endocarditis
It is seen in 3.3% of cases of prosthetic valve endocarditis and more commonly encountered with mechanical prosthetic valves compared to bioprosthetic valves [1]
Summary
The spread of infective endocarditis from valvular structures to surrounding tissues results in periannular complications that may place patients at increased risk for adverse outcomes, including congestive heart failure, heart block, and death. Extension beyond valvular structures may result in aortocavitary fistulization. The incidence of this complication is estimated at 1-2% of all cases of infective endocarditis. It is seen in 3.3% of cases of prosthetic valve endocarditis and more commonly encountered with mechanical prosthetic valves compared to bioprosthetic valves [1]. We report an unusual case of a 68-year-old Bosnian female with a bioprosthetic aortic valve, who developed an extensive aortic root abscess, complicated by an aortico-left atrial intracardiac fistula
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