Aortic root abscess

An aortic root abscess is a serious complication of infective endocarditis and most commonly seen in patients who have had aortic root repair and/or aortic valve replacement.

Aortic root abscess occurs as a complication of infective endocarditis in 10-37% 9. Abscess formation in post-surgical patients (aortic root repair and/or aortic valve replacement) is most commonly encountered in the first 5 years following surgery, most of which occur in the first 2 years.

Fever is almost universal in patients with aortic root abscess. Patients may also present with a new or changing murmur, valvular dehiscence, weight loss, poor appetite, systemic embolisation, or features of congestive heart failure.

Abscesses tend to be saccular in shape, range from 1-3 cm in diameter. Depending on the sinus of origin, they may extend beneath the pulmonary trunk, right pulmonary artery, interventricular septum or mitral annulus.

Patients can be managed with IV antibiotics alone but the prognosis is much greater when revision valve replacement and/or root repair is combined with IV antibiotics.

Thanks to my BFF @kiara_nq for sending me this amazing case!