Aortic coarctation endarteritis: The importance of a systematic echocardiographic study

Pericàs, Pere; Mora, Marta Noris; Fernández-Palomeque, Carlos; Rubio, Montse Massot; Sepúlveda, Andrés Grau; Disdier, Vicente Peral

doi:10.1016/j.jccase.2017.09.005

Cited by 5 publications

(7 citation statements)

References 6 publications

(12 reference statements)

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“…Aortic coarctation creates a favorable anatomical condition for the development of endarteritis due to the change in the blood flow dynamics. This change in flow may result in endothelial damage, increasing the susceptibility to endovascular infections [6,7], possibly triggered by shear stress forces. Aortic grafts also play an important role in the development of endarteritis.…”

Section: Discussionmentioning

confidence: 99%

An Uncommon Presentation of Aortic Endarteritis

Rito,

Oliveira Dias,

Rodrigues

et al. 2024

Cureus

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Endocarditis is an uncommon infectious complication of congenital heart disease (CHD), typically presenting with fever as its primary symptom; however, its occurrence may not always be accompanied by fever. This paper elaborates on a case involving a patient with surgically corrected Berry syndrome and residual aortic coarctation. The clinical presentation of aortic endarteritis in this case manifested as seizures attributed to a hemorrhagic stroke. In this paper, we aim to raise awareness of this infrequent complication of aortic coarctation, as it may present itself with cerebral hemorrhage due to septic microemboli, even in the absence of fever at its initial presentation.

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Section: Discussionmentioning

confidence: 99%

An Uncommon Presentation of Aortic Endarteritis

Rito,

Oliveira Dias,

Rodrigues

et al. 2024

Cureus

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“…Currently, despite advances in the diagnosis and early treatment of aortic coarctation, it is still possible to see patients who reach adulthood without a previous diagnosis. 3,4 Rarely, these patients may debut with symptoms of bacterial endarteritis (BE). 5 Leninger et al made the first report of this pathology in 1946 and, since then, there are few publications with reports of isolated cases.…”

Section: Discussionmentioning

confidence: 99%

“…7 When bacteremia occurs and these germs circulate in the bloodstream, they adhere to the previously established substrate using multiple adhesins and forming vegetations. 3,4 The most frequent germs involved are the same as in infective endocarditis: Streptococcus spp, Staphylococcus spp, Salmonella spp, Escherichia coli, and the Hacek group. 8 In case 1, the bacteremia was most likely caused by gingival manipulation produced by the dental cleaning since this procedure was performed some days before the onset of fever.…”

Section: Discussionmentioning

confidence: 99%

Infectious endarteritis in aortic coarctation: two spectra of an infrequent disease

Santiago,

Karl,

Florez

et al. 2024

Rev. paul. pediatr.

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Objective: To describe two different degrees of clinical commitment and results in the evolution of infectious endarteritis in patients without a previous diagnosis of aortic coarctation. Case description: Two male patients aged 13 and 9 years old were admitted. The first due to a fever for 2 months, which started after dental cleaning, and the second due to high blood pressure, both patients with asthenia and weight loss. In the first case, the transthoracic echocardiogram showed aortic coarctation, and the transesophageal echocardiogram showed the presence of vegetations in the post-coarctation area, without pseudoaneurysms, with blood culture positive for Streptococcus mitis. This patient was treated for six weeks with crystalline penicillin, resolving the infection without complications. The second case was assessed for high blood pressure with a history of fever, and was treated with antibiotics. When performing a transthoracic echocardiogram, aortic coarctation was observed with a saccular image classified as a pseudoaneurysm by angiography and tomography. Blood culture was negative, and the patient developed an episode of hematemesis whose initial etiology could not be determined. Before surgical repair, he had a second episode of copious hematemesis with hypovolemic shock and death. Comments: We need to have a high index of clinical suspicion to establish the diagnosis of aortic coarctation complicated by endarteritis and start the appropriate antibiotic treatment, always maintaining surveillance for the early detection of pseudoaneurysms.

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“… 31 32 Unlike in other congenital heart defects, 11 the role of TEE in the assessment of aortic coarctation is not yet well defined, although it has been used successfully for diagnosis, quantification, and interventional guidance in children. 33 34 35 The reluctance to use TEE may be explained by interference with the angiographic assessment of coarctation and its limitations to image the supra-aortic branches. Conversely, TEE is essential to check for additional intracardiac defects that should always be ruled out, as their association with coarctation is not uncommon.…”

Section: Interventions In Aortic Coarctationmentioning

confidence: 99%

Transesophageal Ultrasound Guidance for Endovascular Interventions on the Aorta

et al. 2022

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Aortic pathologies in general require a multidisciplinary approach and decision-making to integrate elements of clinical acuity, vascular pathology, individual comorbidity, and risk assessment; thus, ideally it is a center with access to multiple imaging modalities and expertise in all treatment options. Besides classic open surgical options, endovascular procedures have been accepted for a variety of aortic pathologies. More recently, novel transcatheter interventions even to the proximal aorta have been introduced, particularly for patients unfit for open surgery. Nevertheless, the role of transesophageal echocardiography to guide percutaneous aortic interventions is not well established, notwithstanding the growing potential as an ancillary tool to guide the procedure and document success.

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Aortic coarctation endarteritis: The importance of a systematic echocardiographic study

Cited by 5 publications

References 6 publications

An Uncommon Presentation of Aortic Endarteritis

An Uncommon Presentation of Aortic Endarteritis

Infectious endarteritis in aortic coarctation: two spectra of an infrequent disease

Transesophageal Ultrasound Guidance for Endovascular Interventions on the Aorta

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