TRICUSPID-VALVE ENDOCARDITIS DUE TO A JET LESION DETECTED BY ECHOCARDIOGRAPHY IN A 27-YEAR-OLD MAN WITH CONGENITAL VENTRICULAR SEPTAL-DEFECT

The case of an non-addict young caucasian with isolated tricuspid valv e endocarditis in congenital ventricular septal defect (VSD) is presen ted. Despite antibiotic treatment the patient suffered from recurrent right sided pneumonias. A computed tomography of the chest revealed an abscess localized in the right lower lung with signs of cavitation. E chocardiography identified a vegetation located at the anterior tricus pid leaflet due to a jet lesion through the VSD. EGG-gated MRI reveale d normal left ventricular. function and localized the septal defect an d a jet against the anterior tricuspid valve leaflet. The patient unde rwent open heart surgery and the VSD was closed. Now, two years later, the patient is free from any symptoms or complications. This case ill ustrates that noninvasive techniques like echocardiography and EGG-gat ed MRI can not only accurately image cardiac anatomy in patients with ventricular septal defect but additionally provide information about t he pathomechanism of the development of jet lesions resulting in valvu lar vegetations. Operative correction of underlying cardiac disease in nonaddicts with complicating tricuspid valve endocarditis might be a favourable treatment especially when antibiotic treatment fails to cur e the Infection.