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Case Reports
. 2018 Sep;8(3):763-768.
doi: 10.1177/1925362118797753. Epub 2018 Aug 31.

Sinus of Valsalva Aneurysm and Infective Endocarditis Involving a Bicuspid Aortic Valve in an Infant With Trisomy 21

Nicole A Croom, Nicole Therrien, Michael Chambliss, Philip C Ursell
Case Reports

Sinus of Valsalva Aneurysm and Infective Endocarditis Involving a Bicuspid Aortic Valve in an Infant With Trisomy 21

Nicole A Croom et al. Acad Forensic Pathol. 2018 Sep.

Abstract

A 19-month-old girl with trisomy 21 and a congenitally bicuspid aortic valve died following a short febrile illness. Autopsy disclosed pericarditis, epimyocardial abscess, infective endocarditis, and a sinus of Valsalva aneurysm. Microscopy demonstrated continuity between the aortic wall and valve leaflet, consistent with an acquired aneurysm. Abnormal hemodynamics associated with the valve malformation likely facilitated endocarditis.

Keywords: Bicuspid aortic valve; Congenital heart defect; Forensic pathology; Infective endocarditis; Sinus of Valsalva aneurysm; Trisomy 21.

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Conflict of interest statement

Disclosures & Declaration of Conflicts of Interest: The authors, reviewers, editors, and publication staff do not report any relevant conflicts of interest

Figures

Image 1:
Image 1:
Epimyocardial abscess. A) Protuberant mass between the right atrial appendage (RAA) and the ascending aorta (Asc Ao). B) A histologic section shows hemorrhage and intense inflammation of the abscess (H&E, x12.5). C) High magnification demonstrates numerous polymorphonuclear cells (H&E, x400).
Image 2:
Image 2:
A close-up view of the left ventricular outflow tract. The right coronary artery ostium (arrowhead) denotes the epicardial position of the abscess. The sinus of Valsalva aneurysm at the conjoined leaflet is dilated as compared with the normal sinus at the noncoronary leaflet.
See this image and copyright information in PMC

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