Infective endocarditis leading to pulmonary pseudoaneurysm and severe pulmonary valve regurgitation: A case report.

RATIONALE: Pulmonary pseudoaneurysm resulting from infective endocarditis is a rare complication in patients with congenital heart disease who have undergone conduit placement.

PATIENT CONCERNS: In this article, we report a rare case of late-onset bacterial infective endocarditis complicated by a pseudoaneurysm and severe pulmonary valve regurgitation in a 16-year-old girl with double-outlet right ventricle, ventricular septal defect, and pulmonary stenosis, who had previously undergone a Rastelli procedure at age 15.

DIAGNOSES: Based on the patient's medical history and transthoracic echocardiography examinations and cardiac computed tomography angiography, a definitive diagnosis of late-onset bacterial infective endocarditis complicated by a pseudoaneurysm and severe pulmonary valve regurgitation was established.

INTERVENTIONS: Given the patient's worsening clinical condition, surgery for ventricular septal defect closure, placement of a new right-ventricle-to-pulmonary-artery conduit with a Gore-tex conduit was conducted.

OUTCOMES: The surgical procedure was successful. The patient was extubated 3 hours postoperatively and received 6 weeks of antibiotic therapy postoperatively, during which no further episodes of fever occurred, and the inflammatory markers decreased to normal levels.

LESSONS: For bacterial infective endocarditis associated with pulmonary pseudoaneurysm and severe pulmonary valve regurgitation, early surgical intervention is essential to mitigate further cardiac dysfunction and improve clinical outcomes.