A Rare Case of Pulmonary Artery Dissection Associated With Infective Endocarditis

Candida tropicalis infectious endocarditis in a dog with a patent ductus arteriosus

A 6-month-old male intact miniature Australian Shepherd presented for surgical consultation for a previously diagnosed patent ductus arteriosus. Echocardiogram revealed a patent ductus arteriosus and a hyperechoic oscillating lesion within the main pulmonary artery. Blood cultures and eventual post-mortem examination revealed Candida tropicalis endocarditis. This case report highlights a rare case of fungal endocarditis with both echocardiographic and post-mortem findings.

Basilar Artery Dissection Complicated with Infective Endocarditis

A 14 year-old boy developed infective endocarditis of the mitral valve caused by Methicillin-sensitive Staphylococcus aureus and became comatose. Isolated basilar artery dissection was initially observed on the 3rd day by magnetic resonance imaging (MRI), ie, it did not exist on day 1. He underwent successful urgent mitral valve repair on the 5th day because of highly mobile vegetations and a newly emerged brain infarction under optimal antibiotic administration. Postoperatively, he recovered well and the basilar artery dissection was found to have recovered on an MRI on the 25th day without any specific intervention. This clinical course indicated that intracranial artery dissection may occur as a complication of infective endocarditis and supports the importance of the careful evaluation of brain MRI in patients with infective endocarditis.

Case report on surgical repair of unusual dissection of arterial duct involving main pulmonary artery in a child with vein of Galen malformation

Background

Dissection involving patent arterial duct (PDA) extending to main pulmonary artery (MPA) is an extremely rare condition.

Case summary

We report a case of complex dissection involving PDA extending to MPA, in a child with vein of Galen malformation. This was surgically corrected under deep hypothermic circulatory arrest, and we describe the pathophysiology and surgical rationale in this report.

Discussion

Management of intracardiac lesion in the presence of intracranial arterio-venous malformations such as vein of Galen is very difficult, and employing deep hypothermic circulatory arrest allows one to manage cerebral protection while offering the visualization of intracardiac anatomy more effectively.