Discussion
Abscesses represent extension of infection into the tissue surrounding
an
infected valve and occur in over half of patients with infected aortic
valve
prosthetics (1). They most commonly develop in the
mitral-aortic
intervalvular fibrosa (MAIF), presumably because of the poor
vascularity of the
cardiac fibrous skeleton as well as the scar tissue left behind from
prior surgery (2).
Pseudoaneurysms are thought to evolve from abscesses which communicate
with
high pressure chambers, such as the left ventricle and aorta. It has
been suggested
that the high pressure generated in these chambers dissects into
structurally
deficient abscess cavities and remodels them into pseudoaneurysms