Aortic Root Abscess With Left Atrial Fistula: A Rare and Life-Threatening Complication of Infective Endocarditis.
Recommended Citation
Mansour W, Peres C, Stephan J, Assaad M. Aortic Root Abscess With Left Atrial Fistula: A Rare and Life-Threatening Complication of Infective Endocarditis. JACC Case Rep. 2026;31(25):108013.
Document Type
Article
Publication Date
6-24-2026
Publication Title
JACC Case Rep
Abstract
BACKGROUND: Aortic root abscesses represent severe complications of infective endocarditis, rarely resulting in fistula formation. Serial imaging is critical for early detection of disease progression and complications.
CASE SUMMARY: A 67-year-old man presented with atrial fibrillation and Streptococcus salivarius bacteremia. Echocardiography revealed aortic insufficiency with subvalvular vegetation. Despite intravenous antibiotics, he developed respiratory distress. Repeat echocardiography showed an aortic root abscess with subaortic-left atrial fistula requiring urgent surgical repair.
DISCUSSION: Despite early diagnosis and guideline therapy, the patient experienced clinical deterioration. This case is notable for the progression of uncomplicated aortic valve vegetations to an aortic root abscess with subaortic-left atrial fistula, noting the role of consistent imaging to identify complications and the need for surgical interventions.
TAKE-HOME MESSAGES: Early diagnosis, multidisciplinary management, and consistent monitoring are critical in infective endocarditis. Surgery remains the gold standard for abscess and fistula repair, with percutaneous methods emerging as a less-invasive option.
PubMed ID
42017853
Volume
31
Issue
25
First Page
108013
Last Page
108013
