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Eur J Cardiothorac Surg 2008;33:735. doi:10.1016/j.ejcts.2007.12.022
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

A blister on the heart: large abscess of the annulus in aortic endocarditis

Thomas Joudinaud*, Franck Baron, Ivan Philip, Nawwar Al Attar

Hôpital Bichat, Service de chirurgie cardiaque, 46, rue Henri Huchard, 75018 Paris, France

Received 13 October 2007; received in revised form 6 December 2007; accepted 11 December 2007.

* Corresponding author. Tel.: +33 1 40 25 80 80; fax: +33 1 40 25 80 80. (Email: thomas.joudinaud{at}bch.aphp.fr).

Key Words: Endocarditis • Aortic valve • Homograft • Annulus abscess • Echocardiography

A 39-year-old man was referred for aortic endocarditis. An echocardiography showed a severe aortic regurgitation with destruction of the aortic valve by vegetations and annulus abscess (Videos 1 and 2). Surgical treatment consisted in removal of all the infected tissue (Fig. 1a) and aortic root replacement by aortic homograft.


Figure 1
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  		Fig. 1. Picture taken in the operating room after the sternotomy. The white arrow shows a large blister corresponding to the abscess of the non-coronary sinus at the base of the aortic root. Blood and valve cultures were positive for Streptococcus salivarius. Complete course of antibiotics with Amoxicillin 12 g daily/6 weeks plus Gentamicin 320 mg daily/2 weeks was begun and dental care was performed. Six months follow-up was uneventful.

 
Appendix A

Supplementary data

Supplementary data associated with this article can be found in the online version at doi:10.1016/j.ejcts.2007.12.022.





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