An Additional Mass in the Aortic Root in a Patient With Infective Endocarditis Scheduled for Excision of a Tricuspid Valve Mass?

摘要

A 23-YEAR-OLD man with a history of intravenous drug abuse presented with mild-to-moderate grade fever of 1 and a half months' duration. Clinical examination was unremarkable, and routine biochemical investigations were within normal limits except for a total leukocyte count of 11,300 cells/mm3. A transthoracic echocardiogram revealed a 16 X 10 mm mass attached to the anterior leaflet of the tricuspid valve (TV), which was bicuspid and regurgitant (4+). Mitral and aortic valves were normal with good right and left' ventricular function. The presumptive diagnosis was infective endocarditis with vegetation on the TV. The patient was scheduled for excision of the mass and repair of the TV under cardiopulmo-nary bypass. Intraoperative transesophageal echocardiography confirmed the preoperative findings, and the mass was seen prolapsing into the right atrium (RA) during systole (Fig 1).