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- Title
A RARE CASE OF SUBACUTE INFECTIVE ENDOCARDITIS AFTER PERCUTANEUS BALLOON PULMONARY VALVULOPLASTY.
- Authors
Crețu, Alex; Crişan, Ioana Maria; Nistor, Oana; Mareş, Răzvan Gheorghiță
- Abstract
Background: Isolated pulmonary stenosis (PS) is a rare condition and accounts for approximately 8% of all congenital heart defects. Balloon pulmonary valvuloplasty (BPV) represents the first line of treatment for PS thanks to its safety and excellent early and intermediate outcome. Although BPV has been performed for over 40 years worldwide, endocarditis after BPV for PS is very rarely seen or reported. Objective: We aim to present the preoperative evaluation and the diagnostic approach in a patient with subacute infective endocarditis after percutaneus balloon valvuloplasty for the pulmonic stenosis. Material and methods: We present the case of a 34-year-old female patient admitted to our clinic complaining of dyspnea and fatigue at low exertion, and a persistent febrile episode about 6 weeks prior. The patient underwent a BPV approximately 7 months ago when the peak transvalvular gradient was reduced after the procedure from 127 to 46 mmHg without significant valvular regurgitation. In addition, the patient is known to have factor V Leiden mutation and antiphospholipid syndrome. Results: The clinical examination revealed a V/VI systolic murmur at the pulmonary area, and the ECG indicated sinus rhythm with a right bundle branch block. Transesophageal echocardiography (TEE) identified a bicuspid pulmonary valve, hypermobile, with a hyperechogenic vegetation attached to the anterior cusp on the pulmonary side, with an area of 0.6 cm2 and turbulent flow at this level. No signs of pulmonary thromboembolism were shown on the thoracic CT scan. Serial blood cultures were negative. Conclusions: IE following BPV is extremely rare but a potentially lethal condition. Diagnosis should be considered in any febrile patient with an underlying congenital defect. TEE remains a valuable imaging method for both diagnosis and monitoring of these patients.
- Subjects
ROMANIA; RARE diseases; PULMONARY stenosis; FATIGUE (Physiology); ENDOCARDITIS; CATHETERIZATION; PREOPERATIVE care; CONFERENCES &; conventions; DYSPNEA
- Publication
Acta Marisiensis. Seria Medica, 2024, Vol 70, p9
- ISSN
2668-7755
- Publication type
Article