Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction

A 64-year-old man on dialysis presented to the emergency department with a fever and chills. Transthoracic echocardiography (TTE) showed small vegetation on the posterior mitral leaflet (PML). Antibiotic therapy was initiated. Two weeks later, right hemiparesis occurred. MRI of the head showed occlu...

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Autores principales: Sasaki, Hideki, Numata, Yukihide, Saito, Jien, Sone, Yoshiaki, Asano, Miki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Cardiac/Thoracic/Vascular Surgery
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118631/
https://www.ncbi.nlm.nih.gov/pubmed/37090267
http://dx.doi.org/10.7759/cureus.36491
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author Sasaki, Hideki
Numata, Yukihide
Saito, Jien
Sone, Yoshiaki
Asano, Miki
author_facet Sasaki, Hideki
Numata, Yukihide
Saito, Jien
Sone, Yoshiaki
Asano, Miki
author_sort Sasaki, Hideki
collection PubMed
description A 64-year-old man on dialysis presented to the emergency department with a fever and chills. Transthoracic echocardiography (TTE) showed small vegetation on the posterior mitral leaflet (PML). Antibiotic therapy was initiated. Two weeks later, right hemiparesis occurred. MRI of the head showed occlusion of the left middle cerebral artery, which suggested an embolism derived from the vegetation. The patient was then referred to the department of cardiovascular surgery. Transesophageal echocardiography (TEE) revealed perforation of the PML and severe mitral regurgitation (MR). The patient underwent mitral valve repair. The postoperative course was uneventful, and the patient was discharged after six weeks of antibiotic treatment. A fresh autologous pericardium is the material of choice to repair the valve.
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spelling pubmed-101186312023-04-21 Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction Sasaki, Hideki Numata, Yukihide Saito, Jien Sone, Yoshiaki Asano, Miki Cureus Cardiac/Thoracic/Vascular Surgery A 64-year-old man on dialysis presented to the emergency department with a fever and chills. Transthoracic echocardiography (TTE) showed small vegetation on the posterior mitral leaflet (PML). Antibiotic therapy was initiated. Two weeks later, right hemiparesis occurred. MRI of the head showed occlusion of the left middle cerebral artery, which suggested an embolism derived from the vegetation. The patient was then referred to the department of cardiovascular surgery. Transesophageal echocardiography (TEE) revealed perforation of the PML and severe mitral regurgitation (MR). The patient underwent mitral valve repair. The postoperative course was uneventful, and the patient was discharged after six weeks of antibiotic treatment. A fresh autologous pericardium is the material of choice to repair the valve. Cureus 2023-03-21 /pmc/articles/PMC10118631/ /pubmed/37090267 http://dx.doi.org/10.7759/cureus.36491 Text en Copyright © 2023, Sasaki et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Cardiac/Thoracic/Vascular Surgery
Sasaki, Hideki
Numata, Yukihide
Saito, Jien
Sone, Yoshiaki
Asano, Miki
Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction
title Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction
title_full Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction
title_fullStr Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction
title_full_unstemmed Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction
title_short Posterior Mitral Leaflet (PML) Perforation due to Infective Endocarditis (IE) Complicated with Cerebral Infarction
title_sort posterior mitral leaflet (pml) perforation due to infective endocarditis (ie) complicated with cerebral infarction
topic Cardiac/Thoracic/Vascular Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118631/
https://www.ncbi.nlm.nih.gov/pubmed/37090267
http://dx.doi.org/10.7759/cureus.36491
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