Abstract
Ruptured sinus of Valsalva aneurysm (RSOV) is an uncommon cause of high output heart
failure. RSOV most commonly opens into the right ventricle followed by the right atrium
and non-coronary cusp involvement is relatively uncommon. Infective endocarditis (IE)
is a rare cause of RSOV. We report an interesting clinical scenario of IE causing
RSOV managed by device closure. A 16-year-old male patient presented to the emergency
department with acute chest pain, fever, and engorged neck veins. On cardiorespiratory
system examination he had features of left ventricular failure. Blood culture revealed
growth of Staphylococcus aureus. Echocardiography and computed tomography aortography confirmed the diagnosis of
9 mm type IV RSOV (non-coronary cusp to right atrium) with vegetation (5 × 6 mm).
The patient refused surgery. When there was no apparent visible vegetation after 6
weeks of antibiotic therapy, we proceeded with 12-mm Amplatzer duct occluder II closure
of the anatomical defect. Monthly follow up has been uneventful for 6 months. As per
our knowledge this is the first ever reported case of documented definitive IE by
S. aureus causing Sakakibara and Konno ruptured Type IV RSOV that has been managed successfully
by device closure.
<Learning objective: Ruptured sinus of Valsalva aneurysm (RSOV) secondary to native valve infective endocarditis
(IE) can occur in apparently healthy young individuals with no predisposing factor.
Device closure is a good therapeutic option in selective cases of RSOV secondary to
native valve IE. Further research is needed to understand the role of device closure
in such clinical settings as an alternative to surgical options.>
Keywords
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Article info
Publication history
Published online: December 08, 2021
Accepted:
November 13,
2021
Received in revised form:
October 14,
2021
Received:
September 7,
2021
Identification
Copyright
© 2021 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
