Here in, we describe a rare case of an eleven years old boy who was
diagnosed with infective endocarditis of a congenitally bicuspid aortic valve
with severe aortic stenosis, severe aortic regurgitation and complicated
by cerebral embolism. He was managed with intravenous antibiotics for
6 weeks. A pre-discharge transthoracic echocardiogram revealed a large,
unruptured pseudoaneurysm of the mitral-aortic inter valvular fibrosa that
was confirmed by transesophageal echocardiography and cardiac MRI.
Patientís parents initially refused surgery and he was managed conservatively
for 3 years. Serial echocardiograms performed during this period
demonstrated progressive dilatation of the left ventricle and aorta, with a
small increase in the size of pseudoaneurysm. Patient was subsequently
referred for surgery (Aortic valve replacement with reconstruction of mitralaortic
intervalvular fibrosa). In conclusion, our case demonstrates that close
clinical follow up and periodic imaging may be a reasonable alternative to
early surgery in managing patients with uncomplicated pseudoaneurysm
of mitral-aortic intervalvular fibrosa.
Pseudoaneurysm, Mitral-aortic intervalvular fibrosa, Bicuspidaortic valve, Infective endocarditis.