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Review
. 2024 Apr 16;19(1):220.
doi: 10.1186/s13019-024-02727-6.

Management of embolic splenic abscess secondary to aortic valve endocarditis - case report and review of literature

Nicolas Nunez-Ordonez  1   2 , Juan Sebastián Luna  3 , Jaime Camacho Mackenzie  4 , Andrés Felipe Jiménez  5   6 , Alejandro González  7 , Andrea J Pico  8 , Carlos F Román  7 , Paulo A Cabrera Rivera  7 , Carlos A Villa Hincapié  9
Affiliations
Review

Management of embolic splenic abscess secondary to aortic valve endocarditis - case report and review of literature

Nicolas Nunez-Ordonez et al. J Cardiothorac Surg. .

Abstract

Background: Splenic abscess is a serious complication associated with infective endocarditis. There is still contradicting evidence regarding the optimal treatment pathway including timing of valve intervention and the approach for managing splenic foci.

Case presentation: We present a case of a hybrid staged approach in which we successfully performed a laparoscopic splenectomy following percutaneous abscess drainage and a delayed aortic valve replacement.

Conclusions: A multidisciplinary teamwork is fundamental in providing optimal care for patients with distant complications associated with infective endocarditis. Our hybrid approach seems safe and feasible.

Keywords: Endocarditis; Laparoscopic splenectomy.; Splenic abscess.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Imaging studies. (a) Transthoracic echocardiogram, showing a large vegetation of the aortic valve (red arrow). (b) Transverse view of brain MRI, showing late subacute infarction with small left occipital hemorrhagic transformation (red arrow). (c) Coronal view of abdominal CT, showing a large unilocular splenic abscess (red arrow)
Fig. 2
Fig. 2
Schematic representation of intraoperative findings and procedure (Source – Author AFJO) (a) A calcified bicuspid valve was found with a large vegetation and an abscess extending through the aortic annulus. (b) Valve implantation technique. The abscess cavity was sealed with pledgeted sutures anchoring the prosthetic valve
Fig. 3
Fig. 3
Proposed Management pathway for patients with splenic abscess secondary to infective endocarditis
See this image and copyright information in PMC

References

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