Native Aortic Valve Endocarditis Complicated by Splenic Infarction and Giant Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm-A Case Report and Brief Review of the Literature

• Published in: Diagnostics (Basel, Switzerland) Vol. 11; no. 2
• Main Authors: Varga, Andreea, Tilea, Ioan, Tatar, Cristina Maria, Iancu, Dragos Gabriel, Jiga, Maria Andrada, Dumbrava, Robert Adrian, Pop, Marian, Suciu, Horatiu
• Format: Report
• Language: English
• Published: 06.02.2021
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics11020251

BACKGROUNDPseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is an unusual complication related to various injuries or conditions which involve the mitro-aortic region; it communicates with the left ventricular outflow tract and is associated with a high-risk of redoubtable complications or sudden death. The cerebral and splenic localizations are frequently seen as manifestations of systemic embolism in infective endocarditis. Currently, there are no specific recommendations related to the diagnosis, management, treatment, or further evolution of patients with P-MAIVF and concomitant splenic infarction. This paper presents the case of a 43-year-old Caucasian woman with a late diagnosis of mixed bicuspid aortic valve disease, affected by an under-detected and undertreated episode of infective endocarditis leading to asymptomatic P-MAIVF. Prime clinical and imagistic diagnosis of splenic infarction indicated further extended investigations were required to clarify the source of embolism. METHODSIntegrated multimodality imaging techniques confirmed the unexpected diagnosis of P-MAIVF. RESULTSThe case had a fatal outcome following an uncomplicated yet laborious cardiac surgery. Patient death was attributed to a malignant ventricular arrhythmia. CONCLUSIONThe present case raises awareness by highlighting an unexplained and unexpected splenic infarction association with P-MAIVF as a result of infective endocarditis related to mixed bicuspid aortic valve disease.