RESUMO
A 71-year-old woman with a history of closed commissurotomy for mitral valve stenosis 44 year ago, was diagnosed with left ventricular aneurysm by transthoracic echocardiography. She had no symptom of left ventricular aneurysm. Since there was a high risk of left ventricular rupture, we decided to undertake surgical treatment. During the surgery, we found artificial material near the left ventricular aneurysm. We resected the aneurysm wall and closed the ventricular wall using felt strip reinforcement. The wall of the aneurysm had no myocardium upon pathological examination. We diagnosed that it was a left ventricular pseudoaneurysm, and it seemed to be formed by blood oozing from the apical repair point of the hole for the dilator to perform mitral valvulotomy. The postoperative course was uneventful and she was discharged on postoperative day 20. Left ventricular pseudoaneurysm often results after myocardial infarction, and reports after cardiac surgery are rare, except in cases after mitral valve replacement. We hereby report our experience with this rare case
RESUMO
Fungal endocarditis is a rare but poor-prognostic disease. It typically occurs in patients with several predisposing factors such as open heart surgery, long term venous catheterization, antibiotic therapy, intravenous drug abuse, hematologic malignancy and AIDS. We report a case of native endocarditis caused by Aspergillus fumigatus, which has not been reported as a causative organism of native valve endocarditis in Korea. A 47 year-old female patients without significant past medical history except pulmonary tuberculosis was admitted because of headache and neck pain. After admission, she developed high feve, new cardiac murmur and signs of multiple systemic embolization. Echocardiography revealed large mobile vegetations. Emergent mitral valve replacement was performed and Aspergillus fumigatus was isolated from the resected vegetation. Despite postoperative amphotericin B therapy, she died of subarachnoidal hemorrhage.