Endocardite em válvula de Eustáquio

Abstract

Eustachian valve endocarditis is a rare condition that affects mostly injectable drug users and patients using pacemakers or central venous catheter. We describe the case of a patient who underwent myocardial revascularization with extracorporeal circulation and who presented Eustachian valve endocarditis in the postoperative period, diagnosed by echocardiogram. The blood culture identified Klebsiella pneumoniae. He received appropriate antibiotic therapy and presented resolution of the condition within four weeks.

Eustachian valve endocarditis

“…The Eustachian valve is a "remnant of the valve of the right sinus venosus, also known as the valve of the inferior vena cava," which rarely persists into adulthood. [2][3][4][5] Eustachian valve endocarditis usually manifests in intravenous drug abusers or those with implanted medical devices or indwelling central venous catheters. Staphylococcus aureus is the causative organism in approximately 53% of cases.…”

“…Staphylococcus aureus is the causative organism in approximately 53% of cases. [1][2][3][4][5][6] However, Eustachian valve endocarditis may be more common than previously thought because routine examination of the Eustachian valve is not commonly performed when looking for endocarditis. 6 Furthermore, the location of the Eustachian valve "does not support high-velocity jets nor pressure gradients," which may explain why endocarditis occurs less frequently in that location.…”

“…emnants of the right sinus venosus can form an embryologic abnormality called the Eustachian valve. [1][2][3] In adults, it is inconsequential and benign without any significant hemodynamic or clinical significance. 1 Most cases of Eustachian valve endocarditis are the result of intravenous drug abuse or occur iatrogenically from indwelling catheters, pacemaker wires, or immunodeficiency.…”

“…4 Staphylococcus aureus accounts for the majority of cases. 1,3 Most are diagnosed on transesophageal echocardiogram rather than transthoracic echocardiogram due to the location of the Eustachian valve. 3 We present a case of a Eustachian valve endocarditis without traditional risk factors.…”

Eustachian valve endocarditis: Rare case reports and review of literature

“…[6] The association of Staphylococcus aureus positivity on blood cultures with intravenous drug abuse ( IVDA ) and indwelling catheters was found to be in 100% of the cases. Other organisms that have been reported so far include Staphylococcus hominis ,[7] Enterococcus cloacae ,[8] Escherichia coli ,[6] Proteus vulgaris ,[6] Streptococcus viridans ,[4] Klebsiella pneumonia [910] and Actinomyces israeli . [11] In our present report, the microorganisms isolated on blood cultures were VRSA and Staphylococcus hominis.…”