Mitral valve infective endocarditis with spread of infection to the pulmonary valve via coronary artery pulmonary artery fistula: a case report

The present report is thought-provoking to describe the diagnosis of and surgical planning for IE. Firstly, when left-sided IE is complicated by lung abscess, a detailed evaluation of the right heart system and the potential for a left-to-right shunt should be performed, keeping in mind the possible presence of right-sided IE. Secondly, even if there is no vegetation at the tricuspid valve, there may be vegetation at the pulmonary valve, in which case an extracardiac left-to-right shunt that does not pass through the tricuspid valve may be present. CAPAF is a rare anomaly, but it causes pulmonary valve IE, which requires PVR.