| A Case of Myocardial Abscess
Complicating Mitral Valve Infective Endocarditis due to Klebsiella
pneumoniae |
(Department of Cardiovascular Surgery, Hyogo Brain
and Heart Center at Himeji, Himeji, Japan)
| Masato Yoshida |
Nobuhiko Mukohara |
Hidefumi Obo |
| Keitaro Nakagiri |
Hiroya Minami |
Tomoki Hanada |
| Ayako Maruo |
Hironori Matsuhisa |
Naoto Morimoto |
| Tsutomu Shida |
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A 65-year-old-man was admitted with
congestive heart failure and septic shock associated with suspected
mitral valve infective endocarditis. An echocardiogram revealed
vegetation attached to the chordae, high density lesions in both
papillary muscles, and severe mitral regurgitation. An emergency
operation was performed. Vegetation was been attached to the
chordae. Multiple myocardial abscesses were noted in both papillary
muscles and surrounding myocardium. However, there were few noticeable
lesions on mitral valve leaflets and annulus. The anterior mitral
leaflet was resected together with the chordae and the papillary
muscles containing the myocardial abscesses. Mitral valve replacement
was performed using a 27mm SJM valve after the other myocardial
abscesses were drained. Klebsiella pneumoniae was cultured
from the vegetation and the myocardial abscesses. Cases of myocardial
abscess associated with infective endocarditis at the site of
the papillary muscles and in the areas of the myocardium are
very rare. It was assumed that the myocardial abscesses were
probably due to the septic state from infective endocarditis,
since myocardial abscesses was recognized in multiple sites and
at a distance from the valve leaflets and annulus.
Jpn. J. Cardiovasc. Surg. 33: 64 -67 (2004) |
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