Mitro-aortic Infective Endocarditis on Bicuspid Aortic Valve Complicated by Pseudoaneurysm of the Left Coronary Sinus: A Case Report

Infective endocarditis (IE) remains a severe disease associated with high morbidity and mortality despite advances in diagnostic imaging and antimicrobial therapy. Bicuspid aortic valve (BAV), the most common congenital cardiac anomaly, is a well-recognized predisposing factor for IE and its complications. Peri-annular extension of infection may lead to abscess formation, fistulization, or, more rarely, pseudoaneurysm of the sinus of Valsalva, a condition associated with life-threatening consequences. We report the case of a 36-year-old man with mitro-aortic infective endocarditis occurring on a bicuspid aortic valve, complicated by a pseudoaneurysm of the left coronary sinus and systemic embolization that underwent a surgical approach. This case highlights the importance of early detection and prompt surgical management of complicated infective endocarditis on a bicuspid aortic valve, and illustrates the key role of multimodality imaging in guiding treatment.