Document Detail


Mitral paravalvular abscess with left ventriculo-atrial fistula in a patient on dialysis.
MedLine Citation:
PMID:  19607702     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Infective endocarditis in hemodialysis patients is challenging but is becoming more common recently. CASE REPORT: A 64-year-old man with end-stage renal disease on hemodialysis presented with infective endocarditis of mitral valve and coronary artery disease after commencing training for home hemodialysis. During a course of antibiotic treatment the patient developed left ventriculo-atrial fistula due to mitral paravalvular abscess. Abscess debridement followed by reconstruction of the mitral annulus with fresh autologous pericardial patch and mitral valve replacement using a mechanical prosthesis with concomitant coronary artery bypass grafting was performed successfully. CONCLUSION: Timely diagnosis, proper antibiotic treatment and early surgical intervention including aggressive debridement should improve the outcome of this high-risk disease.
Authors:
Tadashi Kitamura; James Edwards; Suchi Khurana; Robert G Stuklis
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-07-16
Journal Detail:
Title:  Journal of cardiothoracic surgery     Volume:  4     ISSN:  1749-8090     ISO Abbreviation:  -     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-30     Completed Date:  2009-09-01     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  101265113     Medline TA:  J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  35     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery, Royal Adelaide Hospital, Adelaide SA, Australia. funcorogash@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Abscess / diagnosis,  drug therapy,  microbiology*,  surgery
Anti-Bacterial Agents / therapeutic use
Coronary Angiography
Coronary Artery Bypass
Debridement
Echocardiography, Transesophageal
Endocarditis, Bacterial / diagnosis,  drug therapy,  microbiology
Fistula / microbiology*,  surgery
Heart Atria / microbiology*,  surgery
Heart Valve Diseases / diagnosis,  drug therapy,  microbiology*,  surgery
Heart Valve Prosthesis Implantation
Heart Ventricles / microbiology*,  surgery
Hemodialysis, Home / adverse effects
Humans
Kidney Failure, Chronic / complications,  therapy
Male
Middle Aged
Mitral Valve / microbiology*,  radiography,  surgery,  ultrasonography
Penicillin G / analogs & derivatives,  therapeutic use
Reconstructive Surgical Procedures
Staphylococcal Infections / complications,  diagnosis,  drug therapy,  surgery
Staphylococcus aureus / isolation & purification
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 3264-88-8/benzylpenicillenic acid; 61-33-6/Penicillin G
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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