Patch plasty using autologous pericardium for an anterior mitral leaflet abscess

Abstract

This case deals with a 75-year-old man had recurrent pyrexia during a six-months period of time.
Echocardiography revealed vegetation on the aortic valve and thickening of the anterior leaflet of the mitral valve. Enterococcus faecium was isolated on blood culture. The patient was diagnosed with infective endocarditis and underwent surgery after receiving antimicrobial therapy. Preoperative transesophageal echocardiography showed a mass echo indicative of abscess formation extending from the aortomitral continuity to the left ventricular side of the anterior mitral leaflet. On examination of this site after resection of the aortic valve, 10-mm ulceration, which was thought to be a spontaneous rupture of the abscess, was found on the left ventricular side of the anterior mitral leaflet. The abscess was closed via the transaortic approach using an autologous pericardial patch, and the aortic valve was replaced was. Postoperative transesophageal echocardiography showed that the ulcer on the left ventricular side of the mitral valve was fully repaired.