Mycotic aneurysm of the splenic artery: a rare complication of surgically treated infectious endocarditis at the same time as the causal cardiac lesion.

The authors report the case of a 59 year old woman with mitral valve strept ococcal endocarditis complicating rheumatic valvular disease with several m etastatic septic complications. In addition to ocular and cerebral localisations, the patient developed a v ery rare mycotic aneurysm of the splenic artery. Mitral valve replacement w as necessary because of severe mitral regurgitation with major dilatation o f the left heart chambers. This surgery was performed under high dose hepar in therapy. Large aneurysms of the splenic artery carry a high risk of rupt ure. This splenic artery aneurysm was treated in the same operative session as the valvular disease by a sternolaparotomy: the aneurysm was operated f irst of all, and then valvular replacement was performed. Three years later , the patient is well and cured of the endocarditis. To the authors' knowledge, this is the third report of mycotic aneurysm of the splenic artery and the first case combined with surgery of the infectio us valvular disease and the gastro-intestinal artery aneurysm.