Acute Limb Ischemia as a Complication of Early Infectious Endocarditis Following Surgical Closure of an Atrial Septal Defect: Case Analysis and Literature Review

Background: This study reports the case of a 47-year-old woman who presented with acute pain and coldness in the left lower limb, occurring 5 months after a surgical closure of an atrial septal defect (ASD). Initial examination suggested acute limb ischemia.

Methods: Doppler ultrasound and computed tomography (CT) angiography of the lower extremity arteries confirmed the presence of an occlusion in the left popliteal artery. Echocardiography revealed vegetation on the surgical patch used for the ASD closure. Blood cultures were positive for Staphylococcus aureus.

Treatment: The patient was treated with antibiotics for 6 weeks and underwent replacement of the surgical patch.

Conclusion: This case underscores the importance of screening for endocarditis in patients with systemic embolism and a history of ASD patch closure, even though endocarditis is a rare complication. In cases of systemic emboli and large vegetations, a therapeutic approach often requires surgical removal and replacement of the closure patch.