Rupture of a giant sanitized abscess of mitral valve's annulus in pericardium with tamponade hearts in 4-year-old girl
The most common cause of heart failure in infective endocarditis (IE) is the destruction of the cardiac valve or valves resulting in valve insufficiency. Heart abscesses are the most severe complications of IE and are associated with high mortality rate (up to 25%). Perforation of mitral valve annular abscess resulting in myocardial rupture and hemopericardium is an extremely rare complication. Abscess draining causes the formation of false aneurysms in the heart cavity, which are prone to perforation leading to hemopericardium and are called debrided abscess cavities. Most observations published in the current literature present adult cases. We present a case of 4-year-old girl who underwent successful surgical correction of debrided mitral valve annular abscess (MVAA) that raptured into pericardium and caused cardiac tamponade, which resulted in the formation of the aneurysmal dilatation communicating with the left atrium (LA) and left ventricular (LV) cavities.