[Mycotic aneurysm of the left ventricular free wall complicating aortic valve endocarditis]

Abstract

We report the case of a 34-year-old man with aortic valve infective endocarditis caused by methicillin-resistant Staphylococcus aureus, complicated by an aortic annular abscess. A 23-mm St. Jude HP aortic mechanical prosthesis was implanted. The pre-discharge echocardiogram revealed a mycotic aneurysm of the basal posteroinferior wall, confirmed by cardiac magnetic resonance imaging, and it was decided to reintervene. The aneurysm was closed with a patch and the mitral valve had to be replaced. Although a small leak from the aneurysm patch persisted on the pre-discharge transthoracic echocardiogram, there was no trace of the aneurysm at nine-month re-evaluation. This case illustrates a rare complication of aortic valve endocarditis and shows the evolution of the mycotic aneurysm after closure via a transmitral approach.