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European Journal of Echocardiography Advance Access originally published online on February 5, 2009
European Journal of Echocardiography 2009 10(2):372-373; doi:10.1093/ejechocard/jen326
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Huge tricuspid valve abscess

Carmen M. Manzano Nieto, Isidre Vilacosta*, Cecilia Corros, Carlos Almería and Enrique Rodríguez

Instituto Cardiovascular, Hospital Universitario San Carlos, Madrid, Spain

Received 17 July 2008; accepted after revision 7 December 2008; online publish-ahead-of-print 5 February 2009.

* Corresponding author: Tel.: + 34 91 330 3148; fax: + 34 91 330 3142. E-mail address: ivilac{at}medynet.com


  Abstract

A 60-year-old woman with colorectal adenocarcinoma underwent surgical mass resection in 2003; hepatic segmentectomy due to hepatic metastasis was performed in 2005. A port-a-cath for the administration of chemotherapy was cannulated. In April 2007, the patient developed fever and shivering, and the catheter was removed. Catheter and blood cultures were positive for methicillin-sensitive Staphylococcus aureus. TEE showed a very mobile mass (3 x 2 cm) at the junction of the posterior and anterior leaflets of the tricuspid valve. The mass had large echolucent areas inside, exhibiting an appearance like a ‘ball of wool’ (Panel B). Cardiac MRI confirmed the presence of a mass attached to the tricuspid valve, as shown in the delayed enhancement sequence. At surgery, a ruptured tendinous cord as well as a large abscess within the septal leaflet of the tricuspid valve was found.

Keywords: Endocarditis; Abscess; Tricuspid valve


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