Pseudoaneurysm of the mitral-aortic intervalvular fibrosa following endocarditis and aortic valve surgery in an infant-Case report and exhaustive systematic review of pediatric cases

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa in children diagnosed by echocardiography: Two case reports

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa is rare, particularly in children, and is potentially fatal. This article presents two cases of pediatric mitral-aortic intervalvular fibrosa pseudoaneurysm: one secondary to infective endocarditis and the other confirmed to be congenital in nature. The characteristic echocardiographic manifestations of mitral-aortic intervalvular fibrosa pseudoaneurysm demonstrated in this study will enhance diagnostic efficacy and guide early clinical intervention.

Infective endocarditis caused by Gemella haemolysans in a patient with bicuspid aortic valve: A case report

Gemella haemolysans is a gram-positive coccus, and commensal of the upper respiratory tract and oral mucosa. In rare cases, it has been identified as an opportunistic pathogen in the development of endocarditis. Here, we describe a case of Gemella haemolysans endocarditis in a patient with bicuspid aortic valve. A 14-year-old male presented to our hospital with a 1-month history of intermittent fever. Gemella haemolysans was isolated from the patient's blood cultures. Transesophageal echocardiography revealed severe aortic stenosis and a pseudoaneurysm of the mitral-aortic intervalvular fibrosa. The patient underwent aortic valve replacement with pseudoaneurysm of the mitral-aortic intervalvular fibrosa repair and remained symptom-free during follow-up. This case highlights the importance of considering atypical pathogens as causative agents of infective endocarditis.

Pseudoaneurysm of Mitral-Aortic Intervalvular Fibrosa Imitating a Rhabdomyoma in a Fetus

•P-MAIVF may present prenatally. •Location of and color flow into an atrial mass raises suspicion for P-MAIVF. •The natural history of this presentation is still uncertain.

Prenatally diagnosed pseudoaneurysm of mitral-aortic intervalvular fibrous area

The mitral-aortic intervalvular fibrosa (MAIVF) is an avascular, fibrous structure that provides continuity between the anterior leaflet of the mitral valve and the aortic valve. Pseudoaneurysm of the MAIVF is rare and has been most commonly described in adults and, more rarely, in children following cardiac surgery or endocarditis. Few reports have been published on cases with congenital pseudoaneurysm of the MAIVF. Here, we describe five cases of congenital pseudoaneurysm of the MAIVF identified prenatally and an additional six cases diagnosed postnatally. This is an unusual finding of varying clinical significance, which can be isolated or associated with complex congenital heart disease but, importantly, can be identified and monitored in the fetus. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Infective Endocarditis by Moraxella Species: A Systematic Review

Moraxella catarrhalis is the most clinically relevant species among Moraxella spp. For decades, it was considered to be part of the normal human flora in the upper respiratory tract. However, since the late 1970s, considerable evidence has proposed that M. catarrhalis is an important pathogen in the human respiratory tract. Even though Infective Endocarditis (IE) is rarely caused by Moraxella spp., these infections can be problematic due to the lack of experience in their management. The aim of this study was to systematically review all published cases of IE by Moraxella spp. A systematic review of PubMed, Scopus and Cochrane library (through 8 December 2021) for studies providing epidemiological, clinical, microbiological data as well as treatment data and outcomes of IE by Moraxella spp. was performed. A total of 27 studies, containing data for 31 patients, were included. A prosthetic valve was present in 25.8%. Mitral valve was the most commonly infected site. Fever, sepsis and embolic phenomena were the most common clinical presentations. Cephalosporins, aminoglycosides, aminopenicillins and penicillin were the most commonly used antimicrobials. Overall mortality was 12.9%.