image article Eustachian Valve Endocarditis
Brian Blaker, Davis Leaphart, Alvin M. Timothy, Valerian Fernandes*
Department of Medicine, Section of Cardiology, Medical University of South Carolina, SC, USA
*Corresponding author: Valerian Fernandes, Professor of Medicine, Department of Medicine, Section of Cardiology, Medical University of South Carolina, 25 Courtenay Dr., ART 7063, Charleston, SC 29425, USA. Tel: +18437922579; Fax: +18437928914; Email: fernandv@musc.edu
Received
Date: 13 July, 2018; Accepted Date: 17 July, 2018; Published Date: 24 July, 2018
Citation: Blaker B, Leaphart D, Timothy AM, Fernandes V (2018) Eustachian Valve Endocarditis. Ar Clin Cardiol Res: ACCR-102. DOI: 10.29011/ACCR-102/100002
1. Description
A 58-year-old woman developed pancreatitis
following an endoscopic sphincterotomy. During her 3-month stay in the Intensive
Care Unit (ICU) she developed portal, mesenteric and splenic vein thrombosis with
massive ascites. She also developed persistent bacteremia and fungemia and was
treated with broad spectrum antibiotics and antifungal agents. Initial
transesophageal echocardiogram (TEE) showed no evidence of endocarditis and the
Eustachian valve was normal (Figure
1). She improved initially but
6 weeks later developed persistent bacteremia with methicillin sensitive
staphylococcal epidermidis. TEE now revealed vegetations on the Eustachian
valve (Figure 2). She died 3 days later from septic
complications. Eustachian valve is a vestigial structure, which in the fetus directs
blood from the IVC to the left atrium through the fossa ovalis. Eustachian
valve endocarditis is rare and is diagnosed by TEE. This infection was likely
due to her complicated and prolonged ICU stay with indwelling central lines.
Figure 1: No
evidence of endocarditis and the Eustachian valve as normal.
Figure 2: Vegetation’s
on the Eustachian valve.