Multimodality imaging of aortic root prosthesis dehiscence in prosthetic valve endocarditis
Journal
European Heart Journal-Cardiovascular Imaging
ISSN
2047-2404
2047-2412
Publisher
Oxford University Press (OUP)
Date Issued
2025
Author(s)
Leal-Villarreal, Mario A J
Mercado-Domínguez, Aimée
Gómez-Rodríguez, César
Morales-Arteaga, José Luis
Montañez-Orozco, Álvaro
Type
text::journal::journal article
Abstract
Extract: A 36-year-old man with a history of aortic valve replacement with a woven Dacron tube graft due to aortic regurgitation and aortic root dilation presented to the emergency department with swelling at the level of the sternal notch and retrosternal pain. Blood tests revealed an elevated white blood cell count of 14.83 × 109/L and an increased C-reactive protein level of 5.82 mg/dL. A transthoracic echocardiogram revealed dilatation of all four cardiac chambers with severe systolic dysfunction and a left ventricular ejection fraction of 21%. Additionally, systolic collapse of the woven Dacron tube graft was observed, along with an image suggestive of a retrosternal haematoma (Panels A and B; Supplementary data online, Video S1 and S2). Given the concern for prosthetic valve complications, an urgent transesophageal echocardiogram was performed. It revealed a significant paravalvular leak and vegetations highly suggestive of prosthetic aortic valve endocarditis (Panels D and E; Supplementary data online, Videos S3 and S4). Subsequently, a chest computed tomography angiography documented a 50-cc haematoma in the anterior mediastinum, adjacent to the surgical site, with active contrast extravasation at the level of the aortic root (proximal end of the woven Dacron tube graft) (Panel F; Supplementary data online, Video S5). A soft tissue collection was also noted anterior to the sternal manubrium. The patient was diagnosed with infective endocarditis complicated by dehiscence of the aortic root prosthesis, prompting emergency surgical intervention. However, he died shortly after the procedure. ©The authors ©European Heart Journal-Cardiovascular Imaging ©Oxford University Press (OUP).
License
Acceso Restringido
How to cite
Leal-Villarreal, M. A. J., Mercado-Domínguez, A., Gómez-Rodríguez, C., Morales-Arteaga, J. L., & Montañez-Orozco, Á. (2025). Multimodality imaging of aortic root prosthesis dehiscence in prosthetic valve endocarditis. European Heart Journal - Cardiovascular Imaging, 26(7), 1310–1310. https://doi.org/10.1093/ehjci/jeaf080