CASE REPORT
Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 50-52

A real dilemma: Management of multiple mycotic visceral aneurysms revealing severe endocarditis


Cardiovascular Surgery Unit, University Teaching Hospital Center Mohammed VI, Marrakech, Morocco

Correspondence Address:
Dr. Gaël Biaou
Cardiovascular Surgery Unit, University Teaching Hospital Center Mohammed VI, Marrakech
Morocco
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijves.ijves_43_17

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We present a case of endocarditis, which manifested as an acute-onset of abdominal pain, due to multiple mycotic visceral aneurysms in a 31-year-old man. We initially thought that the pain had a surgical visceral aetiology. However, following a computed tomography scan of the abdomen, he was subsequently found, to have multiple mycotic visceral aneurysms including: two aneurysms in two branches of the superior mesenteric artery; two mycotic aneurysms in the left renal artery associated with bilateral renal and splenic infarcts. Further investigations confirmed that the symptoms were related to mutilated mitral and aortic valves with a high risk of embolization. Our case highlights the surgical priority between repairing the life-threatening multiple aneurysms and the mitral and aortic valves that caused an endocarditis. First, we repaired the mycotic aneurysms by ligation and/or excision. This was then followed by replacement of the aortic and mitral valves. The patient recovered remarkably well.


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