Fatal Evolution of an Aortic Ring Abscess in a Multiple Valve Heart Diseases Patient

The aortic ring abscess is a rare and serious complication of infectious endocarditis. Echocardiography remains the diagnostic key, the treatment is expensive and the prognosis is generally dark .we report the case of a 29 years old patient with multiple value diseases who presented an aortic ring abscess. Observation: This is Miss M. D, 29, known with a rheumatic multiple valve disease: a combined mitral and tricuspid disease and an aortic regurgitation for over 15 years, with a history of multiple hospitalizations. At admission, she was in bad condition, suffered significant weight loss, was pale, a congestive heart failure, mitral regurgitation and stenosis signs, aortic regurgitation and pulmonary hypertension on a background of fever in the long course. The biology test noted anon specific inflammatory syndrome and negative blood cultures. Echocardiography showed, in addition to the multiple valve disease, a fluid collection at the valsalva sinus, suspicious of an abscess and multiple vegetation at the aortic valves. The patient received probabilistic anti biotherapy and congestive heart failure treatment. Surgery was indicated. Under probabilistic anti biotherapy, evolution was favorable at first then the clinical condition has deteriorated resulting in the death of the patient. The check up echo cardiographic noted a significant increase in the volume of the abscess. Conclusion: The aortic ring abscess is a serious complication of infectious endocarditis on native and prosthetic valve. Diagnosis is based mainly on Transthoracic and transosoephagial echocardiography. Surgery is indicated.