Aortic root abscess and anomalous aortic origin of right coronary artery in a 5-year-old child

J Card Surg. 2022 Nov;37(11):3872-3875. doi: 10.1111/jocs.16877. Epub 2022 Sep 2.

Abstract

Background: Aortic root abscess is a rare complication of infective endocarditis in children.

Case report: A 5-year-old boy with infective endocarditis of aortic valve and an anterior aortic root abscess was found to have anomalous aortic origin of right coronary artery from the left coronary sinus on computed tomography scan with contrast.

Result: He was managed surgically by "patch and prosthesis" approach and required aortic root enlargement. Since anomalous aortic origin of right coronary artery is a relative contraindication for a Konno-Rastan aortic root enlargement, a Manouguian procedure was performed.

Conclusion: Anterior aortic root abscesses are rare, the co-existence of anomalous aortic origin of right coronary artery is rarer still and such cases requiring aortic root enlargement are possibly best served by a Manouguian procedure.

Keywords: anomalous aortic origin of right coronary artery [AAORCA]; aortic root abscess; aortic root enlargement; infective endocarditis of aortic valve.

Publication types

  • Case Reports

MeSH terms

  • Abscess / complications
  • Abscess / diagnostic imaging
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Child, Preschool
  • Coronary Vessel Anomalies* / complications
  • Coronary Vessel Anomalies* / diagnostic imaging
  • Coronary Vessel Anomalies* / surgery
  • Coronary Vessels
  • Endocarditis* / complications
  • Endocarditis, Bacterial* / complications
  • Humans
  • Male