20^th European Cardiology Conference

Biography

Biography: Pablo Rodenas

Abstract

31-year-old woman with a diagnosis of mitral valve endocarditis and left sacroiilitis due to streptococcus viridians with intermediate CIM to Penicillin (0,25 ug/ml). In another institution she was treated with ampicillin for 3 weeks and then with oral amoxicillin. She is admitted to our Hospital with fever and petechiae on both lower extremities. Negative blood culture tests to common germs. Transaesophagial echocardiogram in anterior valve of mitral valve: 1.9 by 1.2 cm sessile image, lobulated, mobile, within left auricle, with slight mitral insufficiency. During her admission she shows embolic phenomena in inferior extremities, without compromising peripheral pulses. Assessed by vascular cardio- surgeon, a non-surgical conduct is decided. The patient completes 4 weeks of ampicillin 12g/day plus 240mg/day gentamicin with a favorable evolution. 10 days after being released she complains of pain on left calf. A complete body bone scintigraphy is performed with T99 marked with ciprofloxacin: hyper-uptake in left leg middle third in tibia topography and clear reduction sacroiliac hyper-uptake. Left leg RMI: in the deep sector of superior third there appears a structure with lobulated contours and well-defined margins of 89 mm height and a diameter of 44mm in the axial shaft with re-enforcement of paramagnetic contrast, with iso, hypo and hyper-uptaking areas. Inferior extremities arterial Ecodoppler: in tibio-peroneal trunk and anterior tibia artery source: a saccular, hypoechogenic and heterogeneous structure is found of 10cm-long lobulated contours. Turbulent arterial flow with a positive Doppler signal. Conclusion: a pseudoaneurysm compromising tibio-peroneal trunk with peroneal and tibial posterior arteries with hypoflow. Endoluminal repair of giant sterile mycotic pseudoaneurysm of tibio-peroneal trunk was performed, with satisfactory evolution and without complications.