Streptococcus constellatus community acquired pneumonia with subsequent isolated pulmonic valve endocarditis and abscess formation in a structurally normal heart.

Pulmonic valve infective endocarditis in isolation is a rare clinical entity. The formation of an abscess in the right ventricular outflow tract as a consequence of vegetations affecting the pulmonic valve in a structurally normal heart is extremely rare and has not been reported. We report a case of isolated pulmonic valve endocarditis complicated by a regional abscess formed within the right ventricular outflow tract caused by Streptococcus Constellatus (S. Constellatus), a member of the Streptococcus Milleri group in a young male whose risk factor was alcohol abuse and he was treated medically, a comprehensive literature review on the subject is also reported. Our case is the first reported in literature with infective endocarditis caused by S. Constellatus affecting the pulmonic valve, and the first with pulmonic valve endocarditis and perivalvular abscess formation in a structurally normal heart.

Acute mitral regurgitation: unforeseen new complication of the Impella LP 5.0 ventricular assist device and review of literature.

Impella LP 5.0 (Abiomed) is a relatively new technology that has been used over the last few years as a ventricular assist device to provide full circulatory support for patients presenting with cardiogenic shock. There is limited evidence available in literature with regard to insertion approaches, safety, complications and long-term clinical outcomes. Complications that have been reported are device malfunction, pump displacement, intravascular haemolysis, intra-ventricular thrombosis, functional mitral stenosis due to displacement and local vascular complications at vascular access site. We report here the first case with acute mitral regurgitation due to chordal rupture and flail mitral valve leaflet as a result of Impella device displacement, a new complication. Review of literature is also reported.