P21 INFECTIVE ENDOCARDITIS COMPLICATED BY BLOCKED ATRIAL FIBRILLATION AND AORTIC VALVE RUPTURE: A CASE REPORT

Abstract

Abstract A 63–year–old male patient with a mechanical mitral prosthesis and permanent atrial fibrillation in TAO was hospitalized for heart failure during a SARS CoV–2 infection in April 2022; the transthoracic echocardiogram performed during the hospitalization showed an ejection fraction of 38% The patient was rehospitalized in September 2022 due to worsening general conditions during suspected pneumonia. The hospitalization was complicated by brady AF with heart rate < 30 b.p.m. symptomatic for asthenia and dyspnoea despite the suspension of beta–blocker and digitalis therapy. Therefore, we decided on the implantation of a temporary pacemaker in urgency and subsequently a definitive pacemaker (Essentio MRI – Boston Scientific). During the hospitalization, the clinical conditions continued to be precarious; a transthoracic echocardiogram revealed suspicious formation of endocardic nature at the aortic valve with consensual severe regurgitation. This datum was confirmed with the TEE echo. At this point, in the suspicion of infective endocarditis, antibiotic therapy was set up and the patient was taken to our reference cardiac surgery where he underwent aortic valve replacement with a mechanical prosthesis, reconstruction of the coronary sinus and of the outflow tract of the left ventricle with heterologous pericardial patch. Currently, the patient performs regular clinical follow up at our Center and is in good general condition.