Author + information
- Received June 9, 2011
- Accepted June 16, 2011
- Published online April 17, 2012.
A 62-year-old man with recurrent Staphylococcus aureus endocarditis in the setting of previous mechanical aortic valve replacement, coronary artery bypass graft, and multiple comorbidities was transferred to our institution for further care. A transesophageal echocardiogram demonstrated a large posterior aortic root abscess (*) with a septate cavity that extended into the mitral aortic intervalvular fibrosa (A and B, Online Videos 1 and 2). Color flow Doppler showed communication between the abscess cavity, left atrium, and left ventricle outflow tract (C). A large perforation (blue arrow) at the base of the anterior mitral valve resulted in severe eccentric posterolaterally directed mitral regurgitation (C, Online Video 3). Coronary angiography revealed a fistula from the mid left main trunk with flow directed into the abscess cavity (D, Online Video 4). Computed tomography (E) demonstrated this 5 × 4 × 3-cm periaortic abscess (red arrow) completely surrounding the left main trunk and proximal circumflex artery (orange arrow), which are outlined by coronary calcifications. He was deemed a poor surgical candidate and was discharged with home hospice care. Ao = aorta; LA = left atrium; LAO = left anterior oblique; LV = left ventricle; RA = right atrium; RV = right ventricle.
- Received June 9, 2011.
- Accepted June 16, 2011.
- American College of Cardiology Foundation