The Algerian Cardiac Surgeon
Volume 1, Numéro 1, Pages 84-88
2025-02-01
Cardiomyopathie Hypertrophique Obstructive Compliquée D'une Endocardite Infectieuse: Cas Clinique Et Revue De La Littérature
Auteurs : Amrouche Amal . Haddad Assia . Beghoul Salima Keltoum . Aissaoui Siham . Bourouba Lamia . Abdelkebir Samia . Bouzid Abdelmalek . Djafer Boulanouar .
Résumé
Infective endocarditis (IE) in hypertrophic cardiomyopathy (HCM) presents a rare but challenging clinical scenario, particularly when complicated by left ventricular outflow tract (LVOT) obstruction and severe mitral valve involvement. This case report describes the surgical management of a 31-year-old male with HCM, who developed IE on the mitral valve due to Staphylococcus aureus, likely originating from an oral source. The patient, treated initially with antibiotics, was transferred for surgical intervention due to the high embolic risk and severe obstruction from vegetations and septal bulge. A mitral valve replacement was performed using a mechanical prosthesis, while septal myectomy was withheld due to hemodynamic instability and infection concerns. Postoperative recovery was favorable, with a reduced LVOT gradient, although a residual obstruction persisted. This case illustrates the complexity of managing IE in HCM patients with obstructive anatomy, highlighting the need for individualized surgical approaches in similar cases.
Mots clés
Infective endocarditis, hypertrophic cardiomyopathy, Vegetation, mitral valve replacement, left ventricular outflow tract obstruction, cardiac surgery, case report.
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