This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Arnett, E. N. Articles by Roberts, W. C. Search for Related Content PubMed PubMed Citation Articles by Arnett, E. N. Articles by Roberts, W. C.

Circulation, Vol 54, 140-145, Copyright © 1976 by American Heart Association

ARTICLES

Valve ring abscess in active infective endocarditis. Frequency, location, and clues to clinical diagnosis from the study of 95 necropsy patients

EN Arnett and WC Roberts

Analysis of 95 necropsy patients with active infective endocarditis (AIE) involving 128 native cardiac valves (aortic = 59, mitral = 48, tricuspid = 20, and pulmomic = 1) disclosed 27 patients with ring abscesses involving 30 valves: the aortic valve ring was infected in 24 patients and only an atrioventricular valve ring (mitral in two, and tricuspid in one) in three patients. Comparison of the following parameters showed no significant differences between the 27 patients with and the 68 patients without ring abscess: age, sex, antibiotic treatment or length of treatment, status of the cardiac valve(s) before infection, and the kind of infecting organism. Comparison of the following parameters, however, showed significant (P less than 0.05) differences between the 27 patients with and the 68 patients without valve ring abscess: 1) infection of the aortic valve; 2) occurrence of valvular regurgitation of recent origin; 3) presence of pericarditis; 4) presence of high degree of atrioventricular block; and 5) short duration of symptoms leading to severe debility or death. These five features, therefore, serve as a clinical clues to the presence of valve ring abscess in patients with AIE.

This article has been cited by other articles:

				T. E. Paterick, T. J. Paterick, R. A. Nishimura, and J. M. Steckelberg Complexity and Subtlety of Infective Endocarditis Mayo Clin. Proc., May 1, 2007; 82(5): 615 - 621. [Abstract] [Full Text] [PDF]

				S A Livesey Mitral valve reconstruction in the presence of infection Heart, March 1, 2006; 92(3): 289 - 290. [Abstract] [Full Text] [PDF]

				I. Anguera, J. M. Miro, I. Vilacosta, B. Almirante, M. Anguita, P. Munoz, J. A. S. Roman, A. de Alarcon, T. Ripoll, E. Navas, et al. Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality Eur. Heart J., February 1, 2005; 26(3): 288 - 297. [Abstract] [Full Text] [PDF]

				A. W. Karchmer, D. F. Torchiana, C. U. Chae, N. A. Afridi, and S. L. Houser Case 29-2004 - A 75-Year-Old Woman with Acute Onset of Chest Pain Followed by Fever N. Engl. J. Med., September 16, 2004; 351(12): 1240 - 1248. [Full Text] [PDF]

				H. Siniawski, H. Lehmkuhl, Y. Weng, M. Pasic, C. Yankah, M. Hoffmann, I. Behnke, and R. Hetzer Stentless aortic valves as an alternative to homografts for valve replacement in active infective endocarditis complicated by ring abscess Ann. Thorac. Surg., March 1, 2003; 75(3): 803 - 808. [Abstract] [Full Text] [PDF]

				R. H. Rubin, M. E. King, and E. J. Mark Case 7-2003 - A 43-Year-Old Man with Fever, Rapid Loss of Vision in the Left Eye, and Cardiac Findings N. Engl. J. Med., February 27, 2003; 348(9): 834 - 843. [Full Text] [PDF]

				S. D. Shafran Infective endocarditis and perivalvular abscess: a dangerous duo Can. Med. Assoc. J., July 1, 2002; 167(1): 38 - 39. [Full Text] [PDF]

				N R A Clarke and J C Forfar Aortic root abscess presenting as unstable angina due to extrinsic compression of the left coronary artery Postgrad. Med. J., March 1, 2002; 78(917): 168 - 169. [Abstract] [Full Text] [PDF]

				C. Piper, R. Hetzer, R. Korfer, R. Bergemann, and D. Horstkotte The importance of secondary mitral valve involvement in primary aortic valve endocarditis. The mitral kissing vegetation Eur. Heart J., January 1, 2002; 23(1): 79 - 86. [Abstract] [Full Text] [PDF]

				Y. Niitsuma, Y. Takahara, Y. Sudo, and H. Nakano Acute type A aortic dissection associated with an aortic annular abscess Ann. Thorac. Surg., December 1, 2001; 72(6): 2136 - 2137. [Abstract] [Full Text] [PDF]

				F. J. Baumgartner, B. O. Omari, J. M. Robertson, R. J. Nelson, A. Pandya, A. Pandya, and J. C. Milliken Annular abscesses in surgical endocarditis: anatomic, clinical, and operative features Ann. Thorac. Surg., August 1, 2000; 70(2): 442 - 447. [Abstract] [Full Text] [PDF]

				C Knosalla, Y Weng, A.C Yankah, H Siniawski, J Hofmeister, R Hammerschmidt, M Loebe, and R Hetzer Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess--11 year results Eur. Heart J., March 2, 2000; 21(6): 490 - 497. [Abstract] [PDF]

				R. Choussat, D. Thomas, R. Isnard, P.-L. Michel, B. Iung, G. Hanania, P. Mathieu, M. David, T. du Roy de Chaumaray, G. De Gevigney, et al. Perivalvular abscesses associated with endocarditis: Clinical features and prognostic factors of overall survival in a series of 233 cases Eur. Heart J., February 1, 1999; 20(3): 232 - 241. [Abstract] [PDF]

				N Danchin, G Retournay, O Stchepinsky, C Selton-Suty, P Voiriot, B Hoen, P Canton, J-P Villemot, P Mathieu, and F Cherrier Comparison of long term outcome in patients with or without aortic ring abscess treated surgically for aortic valve infective endocarditis Heart, February 1, 1999; 81(2): 177 - 181. [Abstract] [Full Text]

				R Chaturvedi, M de Leval, and I D Sullivan Urgent homograft aortic root replacement for aortic root abscess in infants and children Heart, January 1, 1999; 81(1): 62 - 66. [Abstract] [Full Text]

				D. E. Gossman, N. Liel-Cohen, and E. Brogi Case 34-1998- A 71-Year-Old Woman with Fever, Hypotension, and Changing Cardiac Findings N. Engl. J. Med., November 12, 1998; 339(20): 1457 - 1465. [Full Text] [PDF]

				D. D. Muehrcke, D. M. Cosgrove III, B. W. Lytle, P. C. Taylor, A. M. Burgar, C. P. Durnwald, and F. D. Loop Is There an Advantage to Repairing Infected Mitral Valves? Ann. Thorac. Surg., June 1, 1997; 63(6): 1718 - 1724. [Abstract] [Full Text]

				T. E. David, C. M. Feindel, S. Armstrong, and Z. Sun RECONSTRUCTION OF THE MITRAL ANULUSA ten-year experience J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1323 - 1332. [Abstract] [Full Text]

				G. Watanabe, A. Haverich, R. Speier, C. Dresler, and H. G. Borst Surgical treatment of active infective endocarditis with paravalvular involvement J. Thorac. Cardiovasc. Surg., January 1, 1994; 107(1): 171 - 177. [Abstract] [Full Text]

				L. Weinstein Life-Threatening Complications of Infective Endocarditis and Their Management Arch Intern Med, May 1, 1986; 146(5): 953 - 957. [Abstract] [PDF]

				M. Zabalgoitia-Reyes, D. J. Mehlman, and J. V. Talano Persistent Fever With Aortic Valve Endocarditis Arch Intern Med, February 1, 1985; 145(2): 327 - 328. [Abstract] [PDF]

				M. J. DINUBILE Surgery in Active Endocarditis Ann Intern Med, May 1, 1982; 96(5): 650 - 659. [Abstract] [PDF]