• Images in cardiology

A 67 year old obese women with hypertension and diabetes was admitted to our hospital because of fever and anaemia. In 1987 a Bjork-Sorin 21 prothesis was implanted for severe aortic regurgitation; abscess formation and valvar ring destruction were found during surgery, and tissue culture yielded meningococcus. The patient remained asymptomatic until 1995, when aortic regurgitation recurred. Surgical repair of the prosthetic ring was successfully undertaken.

Transoesophageal echocardiography was undertaken. As can be seen below, a large aortic abscess is visible in the aortic ring (Abs), which extends to the interatrial septum and left atrium (Ai); vegetation on the aortic prothesis and prosthetic aortic regurgitation are evident.

Staphylococcus epidermidis was isolated in blood cultures. Surgery was performed, confirming the findings. The patient died during the procedure.