[Show abstract][Hide abstract]ABSTRACT: A 60-year-old woman with unoperated single ventricle (SV) had been uneventful until infective endocarditis occurred. Only 9 cases of unoperated SV in patients older than 60 years have been reported. Previous examinations had demonstrated a prolonged PQ interval, double-inlet left ventricle, levo-transposition of the great arteries, and bicuspid pulmonary valve (PV) with severe stenosis with a 104 mm Hg pressure gradient (A to E, Online Video 1). The pulmonary stenosis had resulted in a delicate balance between the sys-temic and pulmonary circulation and was thought to have allowed her long-term survival. On admission, echocardiography revealed mobile vegetation on the PV, suggesting infective endocarditis. Despite antibiotic therapy, severe pulmonary insufficiency developed (F and G, Online Video 2), and broke the hemodynamic balance, resulting in death. Autopsy confirmed the SV and a bicuspid PV with infective endocarditis (H to J).
Full-text available · Article · Mar 2012 · Journal of the American College of Cardiology