Active infective endocarditis of a bicuspid aortic valve causing left ventricular outflow tract pseudoaneurysm and right atrium shunt: A case report

INTRODUCTION AND IMPORTANCE: Left ventricular outflow tract pseudoaneurysm associated with infective endocarditis is a rare but life-threatening condition. CASE PRESENTATION: A 68-year-old man developed infective endocarditis of a bicuspid aortic valve with suspected annulus abscess and was transferred to our department for further treatment. Cardiac workup revealed the formation of a left ventricular outflow tract pseudoaneurysm penetrating the right atrium. We successfully treated the patient with pseudoaneurysm repair using a bovine pericardium patch in combination with aortic valve replacement. The patient was uneventfully discharged after 6-week antibiotic therapy and remained well for the following 2 years. CLINICAL DISCUSSION: Surgery is the recommended treatment for left ventricular outflow tract pseudoaneurysms. Accurate diagnosis and identification of the anatomical conditions are crucial for determining the appropriate treatment. CONCLUSION: When considering the appropriate surgical treatment for left ventricular outflow tract pseudoaneurysm associated with infective endocarditis, pseudoaneurysm repair using a bovine pericardial patch and concomitant aortic valve replacement can be an effective and feasible therapeutic option.