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Background <p>Vegetation in the left ventricular outflow tract (LVOT) due to infective endocarditis (IE) is extremely rare, and no previous reports have described vegetation on the sigmoid septum. We report a rare case of IE with vegetation attached to the sigmoid septum in the LVOT that was successfully managed by surgical resection.</p> Case presentation <p>An 80-year-old woman was admitted with an acute cerebral infarction and fever. Transesophageal echocardiography revealed highly mobile vegetation attached to the sigmoid septum in the LVOT, and blood cultures were positive for Streptococcus agalactiae. Due to the high risk of further embolization, surgical resection was performed using a transaortic approach. The vegetation was easily removed under direct visualization, and the histopathological findings were consistent with IE. The patient’s postoperative course was uneventful, and antibiotic therapy was continued.</p> Conclusions <p>Vegetations in the LVOT carry a significant risk of embolic events and potential LVOT obstruction. A transaortic approach allows for safe and effective removal under good visualization. Early surgical intervention should be considered in similar cases.</p>

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Successful surgical resection of infective endocarditis involving the left ventricular outflow tract and sigmoid septum

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月26日

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  • Tomonori Sano,
  • Kazuma Handa,
  • Masaru Ishida,
  • Toshinari Onishi,
  • Keiij Iwata

摘要

Background

Vegetation in the left ventricular outflow tract (LVOT) due to infective endocarditis (IE) is extremely rare, and no previous reports have described vegetation on the sigmoid septum. We report a rare case of IE with vegetation attached to the sigmoid septum in the LVOT that was successfully managed by surgical resection.

Case presentation

An 80-year-old woman was admitted with an acute cerebral infarction and fever. Transesophageal echocardiography revealed highly mobile vegetation attached to the sigmoid septum in the LVOT, and blood cultures were positive for Streptococcus agalactiae. Due to the high risk of further embolization, surgical resection was performed using a transaortic approach. The vegetation was easily removed under direct visualization, and the histopathological findings were consistent with IE. The patient’s postoperative course was uneventful, and antibiotic therapy was continued.

Conclusions

Vegetations in the LVOT carry a significant risk of embolic events and potential LVOT obstruction. A transaortic approach allows for safe and effective removal under good visualization. Early surgical intervention should be considered in similar cases.