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- Received December 7, 2010
- Accepted January 14, 2011
- Published online August 9, 2011.
A 17-year-old girl presented with several months of unexplained fever and concern for a left circumflex aneurysm based on echocardiogram and cardiac magnetic resonance imaging (A and B, Online Videos 1 and 2). Coronary angiography showed a cystic lesion fed by a branch of the circumflex artery and compressing the distal circumflex artery (C, Online Video 3). She also had moderate to severe mitral regurgitation and regional wall motion abnormality near the mitral valve (C, Online Video 4).
She was taken to the operating room for exploration and repair. Purulent material was expressed from the lesion, and a small hole was noted in the circumflex artery, which was repaired (D). Culture of the abscess did not grow any organisms.
Coronary abscesses have been described after coronary angioplasty and stenting and coronary artery bypass grafting and as a complication of aortic root abscesses. This is the first report of a coronary abscess in a patient without structural heart disease or previous coronary intervention.
- Received December 7, 2010.
- Accepted January 14, 2011.
- American College of Cardiology Foundation