TITLE:
Eustachian Valve Endocarditis—First Staphylococcus epidermidis Case Description
AUTHORS:
Emiliano Andrés Rodríguez-Caulo, José María Novoa-Medina, Diego Valdivia-Miranda, Javier Pérez-López
KEYWORDS:
Endocarditis; Valves; Echocardiography
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.3 No.5,
September
23,
2013
ABSTRACT: Eustachian Valve Endocarditis (EVE) has been considered an extremely rare clinical entity and only 26 adult cases have been reported in literature. Eustachian valve (EV) is an embryological remnant of the sinus venosus, redirecting oxy-genated fetal blood from inferior vena cava across foramen ovale and left atrium. In adults it is considered a benign rudimentary structure and its persistence is uncommon. Only 4% of the population presents a visible and redundant EV by echocardiography. Up to 10% of infective endocarditis (IE) are right sided and occurs predominantly in patients with predisposing factors as intravenous drug abusers, permanent pacemaker wires, central venous lines, or immunologic disorders, predominantly in tricuspid valve, but with a reported incidence up to 3.3% of EVE. Vast majority of EVE are due to S. aureus in 53%-90% cases. We strongly recommend analysing the EV when echocardiography is performed in a patient suspected of having IE, irrespective of whether vegetation in another valve is found. In this case report we describe the first EVE related to Staphylococcus epidermidis in a 35-year-old male with permanent Shaldon-catheter.