Acute Limb Ischemia as a Complication of an Early Infectious Endocarditis after an Atrial Septal Defect Patch Closure
Published: 2022-03-23
Page: 83-87
Issue: 2022 - Volume 4 [Issue 1]
Hanane Mechal *
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Meryem Haboub
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Kawtar Mouamine
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Ahmed El Adaoui
Department of Cardiovascular Surgery, Ibn Rochd University hospital, Casablanca, Morocco.
Salim Arous
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Mohamed El Ghali Benouna
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Abdenacer Drighil
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Leila Azzouzi
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
Selma ElYazidi
Department of Cardiovascular Surgery, Ibn Rochd University hospital, Casablanca, Morocco.
Youssef Toumi
Department of Cardiovascular Surgery, Ibn Rochd University hospital, Casablanca, Morocco.
Rachida Habbal
Department of Cardiology, Ibn Rochd University hospital, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
We report the case of a 47 years-old female who presented to the emergency department with acute pain and coldness in the left lower limb 5 months after surgical closure of atrial septal defects. Initial examination was consistent with a clinical presentation of acute limb ischemia. Doppler ultrasonography and Computed Tomography angiography of the lower extremity arteries confirmed the presence of an occlusion on the left popliteal artery. Echocardiography assessment revealed the presence of vegetation of the surgical atrial septal defect closing patch and blood culture were positive for staphylococcus aureus. The patient was treated by antibiotics for 6 weeks and underwent a surgical patch closure replacement. Screening for endocarditis in patients with systemic embolism and a history of atrial septal defect patch closure is mandatory even though endocarditis is a rare complication. Therapeutic approach in case of systemic emboli and large vegetation often requires surgical removal and replacement of the closure patch.
Keywords: Early infectious endocarditis, antibiotic prophylaxis, atrial septal defects, surgical patch closure