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Isolated myocardial abscess cavity: An incidental finding on intraoperative transesophageal echocardiography


1 Department of Cardiac Anaesthesia, Jeevan Rekha Superspeciality Hospital, Central Spine, Jagatpura, Jaipur, Rajasthan, India
2 Department of Anaesthesia, Fortis Escorts Hospital, Malviya Nagar, Jaipur, Rajasthan, India
3 Department of Anaesthesia, SMS Medical College, JLN Marg, Jaipur, Rajasthan, India
4 Department of Cardiac Anaesthesia, Fortis Escorts Hospital, Malviya Nagar, Jaipur, Rajasthan, India

Correspondence Address:
Mukesh Garg
Department of Cardiac Anaesthesia, Jeevan Rekha Superspeciality Hospital, Central Spine, Jagatpura, Jaipur - 302 025, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_136_19

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Year : 2021  |  Volume : 24  |  Issue : 3  |  Page : 411-414

 

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Myocardial abscess is a suppurative infection of myocardium, endocardium, native or prosthetic valves, perivalvular structures and cardiac conduction system. It develops in about 20% of patients with infective endocarditis. Due to avascular and fibrous structures, valvular regions are commonly involved. More precisely, aortic valve (AV) rings area; native or prosthetic valve is usually affected. Occurrence of myocardial abscess within free wall of the left ventricle (LV) without any evidence of infective endocarditis is a rare phenomenon; and infrequently reported in medical literature. We report a case of myocardial abscess cavity within the anterior wall of the LV, in a patient who underwent open heart surgery for severe AV stenosis. This was an incidental intraoperative transesophageal echocardiography (TEE) finding without any other evidence of infective endocarditis. The stenotic AV was replaced, along with surgical drainage and closure of the cavity. Postoperatively, patient was managed on empirical antibiotics according to infective endocarditis guidelines.






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1 Department of Cardiac Anaesthesia, Jeevan Rekha Superspeciality Hospital, Central Spine, Jagatpura, Jaipur, Rajasthan, India
2 Department of Anaesthesia, Fortis Escorts Hospital, Malviya Nagar, Jaipur, Rajasthan, India
3 Department of Anaesthesia, SMS Medical College, JLN Marg, Jaipur, Rajasthan, India
4 Department of Cardiac Anaesthesia, Fortis Escorts Hospital, Malviya Nagar, Jaipur, Rajasthan, India

Correspondence Address:
Mukesh Garg
Department of Cardiac Anaesthesia, Jeevan Rekha Superspeciality Hospital, Central Spine, Jagatpura, Jaipur - 302 025, Rajasthan
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_136_19

Rights and Permissions

Myocardial abscess is a suppurative infection of myocardium, endocardium, native or prosthetic valves, perivalvular structures and cardiac conduction system. It develops in about 20% of patients with infective endocarditis. Due to avascular and fibrous structures, valvular regions are commonly involved. More precisely, aortic valve (AV) rings area; native or prosthetic valve is usually affected. Occurrence of myocardial abscess within free wall of the left ventricle (LV) without any evidence of infective endocarditis is a rare phenomenon; and infrequently reported in medical literature. We report a case of myocardial abscess cavity within the anterior wall of the LV, in a patient who underwent open heart surgery for severe AV stenosis. This was an incidental intraoperative transesophageal echocardiography (TEE) finding without any other evidence of infective endocarditis. The stenotic AV was replaced, along with surgical drainage and closure of the cavity. Postoperatively, patient was managed on empirical antibiotics according to infective endocarditis guidelines.






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