AVR with Root Abscess

 

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This individual had a bioprosthetic AVR performed along with an ascending aortic graft, which then became infected. Note the large confined abscess cavity in this TEE long axis view around the graft material and within the native aortic space.

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The short axis view shows the extend of the root abscess. Note the herogenenous echodense material which is likely filled with necrotic fluid and pus.

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Interestingly most of the infection was confined outside the graft. There was no significant aortic insufficiency demontrated by color Doppler.

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An off standard axis view shows the abscess cavity viewed laterally.  It has started to encroach onto right sided structures but is still confined at the time of this examination.