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Ann Thorac Surg 2009;87:963. doi:10.1016/j.athoracsur.2008.07.074
© 2009 The Society of Thoracic Surgeons
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Images in Cardiothoracic Surgery

Prosthetic Aortic Valve Abscess Producing Intermittent Right Coronary Artery Compression

Vijayasimha R. Pothula, MDc, Alain Waked, MDa, Scott M. Sadel, MDb, Joseph T. McGinn, Jr, MDc,*, Joy Cai, MDb, Duccio Baldari, MDa

a Department of Cardiology, Staten Island University Hospital Staten Island, New York
b Department of Cardiac Anesthesia, Staten Island University Hospital Staten Island, New York
c Department of Cardiothoracic Surgery, Staten Island University Hospital Staten Island, New York

* Address correspondence to Dr McGinn, Department of Cardiothoracic Surgery, Staten Island University Hospital, Staten Island, NY 10305 (Email: drsimham{at}yahoo.com).

A 61-year-old man with a history of aortic and mitral valve replacement was admitted with prosthetic valve infective endocarditis after prolonged antibiotic therapy. Electrocardiogram showed no signs of myocardial ischemia. Transthoracic echocardiography showed a prosthetic aortic valve with vegetations. Preoperative coronary catheterization showed intermittent compression of the right coronary artery (Figs 1A and 1B; arrows). Intraoperative transesophageal echocardiography showed an echolucent mass adjacent to the anterior part of sinus of Valsalva expanding and contracting with the cardiac cycle (Figs 2A–C). This confirmed the cause of compression of the RCA. (AB = abscess cavity; AO = aorta; AP = prosthetic valve; PA = proximal common pulmonary artery; SVC = superior vena cava; SV = sinus of Valsalva; VG = vegetation). The patient subsequently underwent debridement of abscess and pericardial patch repair. The aortic valve was replaced with a mechanical aortic valve.


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Right arrow Articles by Baldari, D.
Related Collections
Right arrow Coronary disease
Right arrow Valve disease

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