Unicuspid Aortic Valve Concomitant With Infective Endocarditis And Severe Aortic Regurgitation In A Patient With Covid-19

Background Unicuspid aortic valve (UAV) is a rare congenital heart disease We report a case of a young male who presented with COVID-19 and found to have UAV concomitant with infective endocarditis (IE) and severe aortic regurgitation (AR) Case 28-year-old male with history of polysubstance abuse presented with worsening generalized weakness, fever, cough, and respiratory distress COVID-19 PCR was positive He developed acute hypoxic respiratory failure requiring mechanical ventilation Hospital course was complicated by septic shock requiring multiple pressors, MRSA pneumonia, serratia marcescens bacteremia, PEA arrest due to hypoxia, acute kidney injury requiring hemodialysis, and acute liver failure Decision-making TTE revealed low normal LVEF, moderate-severe AR, and prolapsing aortic valve leaflet TEE revealed UAV with vegetation on AV leaflet and severe AR Cardiothoracic surgery recommended aortic valve replacement after medical optimization Prognosis of patients with UAV complicated by IE and severe AR and sepsis with multi organ failure is very poor In our case, his condition was further complicated by COVID-19 Our case possessed unique challenges in management of this rare disease during COVID-19 pandemic Unfortunately, our patient eventually succumbed due to complications from multi organ failure Conclusion We discussed a case of a patient with COVID-19 with multi organ failure who is found to have UAV concomitant with IE and severe AR [Formula presented]