Intracardiac Fistulae: A Rare Complication of Infective Endocarditis

Authors

  • Ali M. Alizzi
  • Mandana Master
  • David Williams

DOI:

https://doi.org/10.1532/HSF98.20111007

Abstract

We present the case of a diabetic gentleman who was admitted to the hospital with an infected right foot. Swabs were positive for Staphylococcus aureus and Pseudomonas aeruginosa. His right big toe was amputated. Postoperatively, the patient experienced recurrent episodes of chest pain. He was therefore transferred to the coronary care unit, where he deteriorated rapidly. The patient was subsequently transferred to intensive care. Transthoracic and transesophageal echocardiograms revealed evidence of aortic dissection, but this finding was not confirmed in a computed tomography scan. The patient subsequently experienced cardiac arrest and died. The postmortem examination revealed no aortic dissection but did show a vegetation on the mitral valve with a fistula that tracked into a ruptured epicardium.

References

Ananthasubramanium K. 2005. Clinical and echocardiographic features of aorto-atrial fistulas. Cardiovascular Ultrasound 3:1.nAnguera I, Miro JM, Vilacosta I 2005. Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and endocardiographic features of 76 cases and risk factors for mortality. Eur Heart J 26:288-97.nBaumgartner FJ, Omari BO, Robertson JM 2000. Annular abscesses in surgical endocarditis: anatomic, clinical, and operative features. Ann Thorac Surg 70:442-7.nDaniel WG, Mügge A, Martin RP 1991. Improvement in the diagnosis of abscesses associated with endocarditis by transesophageal echocardiography. N Engl J Med 324:795-800.nDelahaye F, Celard M, Roth O, de Gevigney G. 2004. Indications and optimal timing for surgery in infective endocarditis. Heart 90:618-20.nEvangelista A, Gonzalez-Alujas MT. 2004. Echocardiography in infective endocarditis. Heart 90:614-7.nGraupner C, Vilacosta I, SanRomán J 2002. Periannular extension of infective endocarditis. J Am Coll Cardiol 39:1204-11.nKang N, Wan S, Ng CS, Underwood MJ. 2009. Periannular extension of infective endocarditis. Ann Thorac Cardiovasc Surg 15:74-81.nLester SJ, Wilansky S. 2007. Endocarditis and associated complications. Crit Care Med 35(suppl):S384-91.nMylonakis E, Calderwood SB. 2001. Infective endocarditis in adults. N Engl J Med 345:1318-30.nReynolds HR, Jagen MA, Tunick PA, Kronzon I. 2003. Sensitivity of transthoracic versus transesophageal echocardiography for the detection of native valve vegetations in the modern era. J Am Soc Echocardiogr 16:67-70.nRyan EW, Bolger AF. 2000. Transesophageal echocardiography (TEE) in the evaluation of infective endocarditis. Cardiol Clin 18:773-87.nShanwise JS, Martin RP. 1996. Assessment of endocarditis and associated complications with transesophageal echocardiography. Crit Care Clin 12:411-27.nShapiro SM, Young E, De Guzman S 1994. Transesophageal echocardiography in diagnosis of infective endocarditis. Chest 105:377-82.nTak T, Reed KD, Haselby RC, McCauley CS Jr, Shukla SK. 2002. An update on the epidemiology, pathogenesis and management of infective endocarditis with emphasis on Staphylococcus aureus. WMJ 101:24-33.n

Published

2011-10-13

How to Cite

Alizzi, A. M., Master, M., & Williams, D. (2011). Intracardiac Fistulae: A Rare Complication of Infective Endocarditis. The Heart Surgery Forum, 14(5), E322-E325. https://doi.org/10.1532/HSF98.20111007

Issue

Section

Articles

Most read articles by the same author(s)