What question did this study set out to answer?

To describe the presentation, molecular diagnosis, and complex surgical management of a destructive Coxiella burnetii aortic root abscess following transcatheter aortic valve replacement.

September 15, 2025JACC Case ReportsOpen Access

Aortic Root Abscess Secondary to Coxiella burnetii Following TAVR

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Authors

PBParnia Behinaein OJOmar A. Jarral SPStevan S. Pupovac

Discussion

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Overview

Case report demonstrates invasive Coxiella burnetii aortic root abscess after transcatheter valve replacement, highlighting molecular testing and radical surgery for culture-negative infections.

Key Points

To describe the presentation, molecular diagnosis, and complex surgical management of a destructive Coxiella burnetii aortic root abscess following transcatheter aortic valve replacement.
Assessed a 67-year-old male with a prior transcatheter aortic valve replacement presenting with chest pain using multimodality cardiac imaging and standard blood cultures.
Identified culture-negative infection using Coxiella burnetii serology and microbial cell-free DNA sequencing (Karius testing).
Performed a surgical hemi-Commando procedure consisting of radical debridement, aortic root homograft replacement, and aorto-mitral curtain reconstruction, followed by a 2-year regimen of doxycycline and hydroxychloroquine.
Echocardiography demonstrated an extensive aortic root abscess extending directly into the anterior mitral leaflet despite negative standard blood cultures.
Microbial cell-free DNA testing and serology confirmed invasive Coxiella burnetii as the causative pathogen of prosthetic valve endocarditis.
Radical surgical reconstruction combined with prolonged dual antimicrobial therapy eliminated the active infection and resulted in postoperative clinical stabilization.

Cite This Study

Behinaein et al. (2025) studied this question.

synapsesocial.com/papers/6aa2499673e53a3c1f6ed4e3 https://doi.org/10.1016/j.jaccas.2025.105425

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September 15, 2025JACC Case ReportsOpen Access

Aortic Root Abscess Secondary to Coxiella burnetii Following TAVR

View Full Paper

Ask AI

Bookmark

Authors

PBParnia Behinaein OJOmar A. Jarral SPStevan S. Pupovac

Discussion

Member takes

Overview

Case report demonstrates invasive Coxiella burnetii aortic root abscess after transcatheter valve replacement, highlighting molecular testing and radical surgery for culture-negative infections.

Key Points

To describe the presentation, molecular diagnosis, and complex surgical management of a destructive Coxiella burnetii aortic root abscess following transcatheter aortic valve replacement.
Assessed a 67-year-old male with a prior transcatheter aortic valve replacement presenting with chest pain using multimodality cardiac imaging and standard blood cultures.
Identified culture-negative infection using Coxiella burnetii serology and microbial cell-free DNA sequencing (Karius testing).
Performed a surgical hemi-Commando procedure consisting of radical debridement, aortic root homograft replacement, and aorto-mitral curtain reconstruction, followed by a 2-year regimen of doxycycline and hydroxychloroquine.
Echocardiography demonstrated an extensive aortic root abscess extending directly into the anterior mitral leaflet despite negative standard blood cultures.
Microbial cell-free DNA testing and serology confirmed invasive Coxiella burnetii as the causative pathogen of prosthetic valve endocarditis.
Radical surgical reconstruction combined with prolonged dual antimicrobial therapy eliminated the active infection and resulted in postoperative clinical stabilization.

Cite This Study

Behinaein et al. (2025) studied this question.

synapsesocial.com/papers/6aa2499673e53a3c1f6ed4e3 https://doi.org/10.1016/j.jaccas.2025.105425

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