Gemella Endocarditis Presenting as an ST-Segment-Elevation Myocardial Infarction.

Acute myocardial infarction from septic embolization is a rare initial presentation of endocarditis. We report the case of a 67-year-old man who presented with acute chest pain, in whom emergency cardiac catheterization revealed findings that suggested coronary embolism. The patient was found to have Gemella endocarditis, with its initial presentation an embolic acute ST-segment-elevation myocardial infarction.

Valve-sparing aortic root replacement after cocaine-induced acute ascending aortic dissection.

Cocaine-induced ascending aortic dissection is being recognized with increasing frequency. We present two cases of patients treated using valve-sparing aortic root replacement after cocaine-induced aortic root dissection. Valve-sparing aortic root replacement represents an alternative surgical technique that may be particularly well-suited toward this younger, noncompliant patient population.

Should aortas in patients with bicuspid aortic valve really be resected at an earlier stage than tricuspid? CON.

Bicuspid aortic valve (BAV)-associated aortopathy is a complex phenomenon, and the current lack of univocal interpretation of its causes and treatment can be ascribed to the multiform nature of its clinical presentation. Although there is strong bias in the literature favoring more aggressive treatment of ascending aortic dilatation in patients with BAV, evidence supporting this opinion is lacking. This review discusses some of the relevant issues relating to causation to facilitate a better analysis of the current recommendations used to guide surgical management, and concludes that treatment should be tailored by individual valvular pathology, clinical phenotype, and relevant comorbidities, using well-documented evidence-based clinical size criteria.