Active infective endocarditis of a bicuspid aortic valve causing left ventricular outflow tract pseudoaneurysm and right atrium shunt: A case report

Introduction and importanceLeft ventricular outflow tract pseudoaneurysm associated with infective endocarditis is a rare but life-threatening condition.Case presentationA 68-year-old man developed infective endocarditis of a bicuspid aortic valve with suspected annulus abscess and was transferred to our department for further treatment. Cardiac workup revealed the formation of a left ventricular outflow tract pseudoaneurysm penetrating the right atrium. We successfully treated the patient with pseudoaneurysm repair using a bovine pericardium patch in combination with aortic valve replacement. The patient was uneventfully discharged after 6-week antibiotic therapy and remained well for the following 2 years.Clinical discussionSurgery is the recommended treatment for left ventricular outflow tract pseudoaneurysms. Accurate diagnosis and identification of the anatomical conditions are crucial for determining the appropriate treatment.ConclusionWhen considering the appropriate surgical treatment for left ventricular outflow tract pseudoaneurysm associated with infective endocarditis, pseudoaneurysm repair using a bovine pericardial patch and concomitant aortic valve replacement can be an effective and feasible therapeutic option.