The Ultimate Development of Mitral Valve Endocarditis: Atrioventricular Separation, Atrioventricular Groove Abscess and Hemorrhagic Pericarditis

Fernando A. Atik, Gosta B. Pettersson, Gardar Sigurdsson, Gonzalo V. Gonzalez-Stawinski, Ellen Mayer Sabik, Alice Kim, Lars G. Svensson
Departments of Thoracic and Cardiovascular Surgery, Cardiovascular Medicine and Infectious Diseases, The Cleveland Clinic Foundation, Cleveland, Ohio, USA
 

A 52-year-old non-insulin-dependent diabetic man presented with cerebral emboli and mitral valve endocarditis with posterior leaflet vegetations and perforation. Surgical intervention demonstrated hemorrhagic pericarditis and an atrioventricular groove abscess. Extensive debridement of the pericardium, valve and abscess cavities, reconstruction of the mitral annulus with a patch of fresh autologous pericardium,

and mitral valve replacement with a pericardial bioprosthesis was performed. The chest was left open. Postoperatively, the patient required dialysis and prolonged mechanical ventilation, but recovered well without recurrent endocarditis and was discharged home after 40 days.

The Journal of Heart Valve Disease 2005;14:29-32
 
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