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Current Research: Cardiology

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Missed aortic valve endocarditis resulting in complete atrioventricular block and redo aortic valve replacement

Author(s): Amer Harky MRCS*, Miruna Popa, Megan Garner and Alex Shipolini

BACKGROUND: Infective endocarditis is a rare disease associated with high morbidity and mortality. As a result, early diagnosis, prompt antibiotic treatment with or without surgical intervention is crucial in the management of such a condition.

CASE REPORT: We report a case of missed infective endocarditis of the aortic valve. The patient underwent mechanical aortic valve replacement, with the native valve sent for histopathological analysis. On re-admission with syncope and shortness of breath he was noted to have complete heart block and severe aortic regurgitation and paravalvular leak.

DISCUSSION: On review of the histopathology, endocarditis was identified which had not been acted upon at the original operation. The patient underwent redo aortic valve replacement with insertion of a permanent pacemaker and treatment with appropriate antibiotics.

CONCLUSION: We highlight the importance of following up histopathological results as well as the need for multidisciplinary treatment of endocarditis with a combination of surgical and antibiotic therapy.


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