{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T05:09:28Z","timestamp":1737781768776,"version":"3.33.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The mitroaortic intervalvular fibrosa is an avascular structure near the left ventricular outflow tract, between the mitral and aortic valves. Mitroaortic intervalvular fibrosa complications, such as tamponade, hemopericardium, and abscesses, are rare and often diagnosed postmortem. On the other hand, the COVID-19 pandemic notably impacted pediatric patients with congenital heart diseases, who frequently presented cardiac complications including arrhythmias, elevated troponins, myocarditis, and heart failure. However, the rupture of the mitroaortic intervalvular fibrosa kept being unusual, making this case a rare presentation of a COVID-19 complication. The objective of this text is to present an infrequent presentation of COVDI-19 complications, and the approach given at our institution which proved to be effective, and further supports the positive findings described in the literature regarding the utility of extracorporeal hemofiltration membranes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>A case of 15-year-old female, without any prior risk factors or cardiac comorbilities, who developed acute myocarditis, linked to COVID-19 Multisystem Inflammatory Syndrome is presented. She deteriorated despite adequate treatment, presenting mitroaortic intervalvular fibrosa rupture, leading to urgent surgical repair and requiring extracorporeal membrane hemofiltration for cytokine removal, therapeutic approach that proved to be effective. Postoperatively, she received intensive care and antibiotics, showing significant cardiac improvement. Noteworthy, hemofiltration was crucial in managing the cytokine storm, contributing to her recovery and subsequent discharge for continued medical management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>An abscess of the mitroaortic intervalvular fibrosa, though rare, represents a significant challenge to clinicians to diagnose. In patients with a history of COVID-19, especially when multisystem inflammatory syndrome is suspected, thorough evaluation is warranted to rule out cardiovascular complications, even in the absence of pre-existing cardiac conditions. This case contributes to our evolving understanding of the cardiovascular implications of COVID-19 and underscores the potential utility of various approaches, including the use of filtration membrane technologies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s43044-025-00609-3","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T08:25:47Z","timestamp":1737707147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal membrane therapy in a case of ruptured abscess on the mitroaortic intervalvular fibrosa associated to multisystem inflammatory syndrome: a case report"],"prefix":"10.1186","volume":"77","author":[{"given":"Lina P.","family":"Monta\u00f1a-Jimenez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana M.","family":"Aristizabal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0431-8035","authenticated-orcid":false,"given":"Carlos A.","family":"Guzm\u00e1n-Serrano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar Cely","family":"Reyes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Fernando","family":"V\u00e9lez Moreno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gast\u00f3n","family":"Castillo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"609_CR1","doi-asserted-by":"publisher","first-page":"100764","DOI":"10.1016\/j.ijcha.2021.100764","volume":"33","author":"B Haghighi Aski","year":"2021","unstructured":"Haghighi Aski B, Manafi Anari A, Abolhasan Choobdar F, Zareh Mahmoudabadi R, Sakhaei M (2021) Cardiac abnormalities due to multisystem inflammatory syndrome temporally associated with Covid-19 among children: a systematic review and meta-analysis. Int J Cardiol Heart Vasc 33:100764. https:\/\/doi.org\/10.1016\/j.ijcha.2021.100764","journal-title":"Int J Cardiol Heart Vasc"},{"issue":"4","key":"609_CR2","doi-asserted-by":"publisher","first-page":"461","DOI":"10.14744\/SEMB.2022.23921","volume":"56","author":"M Karabulut","year":"2022","unstructured":"Karabulut M, Aktas D, Yasar B, Petmezci E, Karabulut ND (2022) Cardiac evaluation in children with multisystem inflammatory syndrome associated with SARS-CoV-2. Sisli Etfal Hastan Tip Bul 56(4):461\u2013465. https:\/\/doi.org\/10.14744\/SEMB.2022.23921","journal-title":"Sisli Etfal Hastan Tip Bul"},{"issue":"8","key":"609_CR3","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1016\/j.jaccas.2020.05.071","volume":"2","author":"M Kuroda","year":"2020","unstructured":"Kuroda M, Yamamoto H, Nakamura Y (2020) Infective endocarditis complicated by pseudoaneurysm of the mitral-aortic intervalvular fibrosa without valvular involvement. JACC Case Rep 2(8):1212\u20131216. https:\/\/doi.org\/10.1016\/j.jaccas.2020.05.071","journal-title":"JACC Case Rep"},{"issue":"7","key":"609_CR4","doi-asserted-by":"publisher","first-page":"2138","DOI":"10.1111\/jocs.16507","volume":"37","author":"L Ku","year":"2022","unstructured":"Ku L, Lv H, Ma X (2022) An abscess of mitral aortic intervalvular fibrosa mimicking an intracardiac mass. J Card Surg 37(7):2138\u20132141. https:\/\/doi.org\/10.1111\/jocs.16507","journal-title":"J Card Surg"},{"key":"609_CR5","unstructured":"Ramos Tuarez FJ, Yelamanchili VS, Law MA (2024) Cardiac Abscess. In: StatPearls, Treasure Island (FL): StatPearls Publishing. Accessed 22 Apr 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK459132\/"},{"issue":"8","key":"609_CR6","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1016\/j.jaccas.2020.05.078","volume":"2","author":"MCP Nunes","year":"2020","unstructured":"Nunes MCP, Ferrari TCA (2020) Mitral-aortic intervalvular fibrosa. JACC Case Rep 2(8):1217\u20131219. https:\/\/doi.org\/10.1016\/j.jaccas.2020.05.078","journal-title":"JACC Case Rep"},{"key":"609_CR7","doi-asserted-by":"publisher","first-page":"1213111","DOI":"10.3389\/fmicb.2023.1213111","volume":"14","author":"Y Zhao","year":"2023","unstructured":"Zhao Y et al (2023) COVID-19 and the cardiovascular system: a study of pathophysiology and interpopulation variability. Front Microbiol 14:1213111. https:\/\/doi.org\/10.3389\/fmicb.2023.1213111","journal-title":"Front Microbiol"},{"issue":"1","key":"609_CR8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2217\/fvl-2022-0048","volume":"18","author":"F Long","year":"2023","unstructured":"Long F et al (2023) Update on the treatment of multisystem inflammatory syndrome in children associated with COVID-19. Future Virol 18(1):63\u201374. https:\/\/doi.org\/10.2217\/fvl-2022-0048","journal-title":"Future Virol"},{"key":"609_CR9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.665824","volume":"12","author":"JC Ruiz-Rodr\u00edguez","year":"2021","unstructured":"Ruiz-Rodr\u00edguez JC et al (2021) Hemadsorption as a treatment option for multisystem inflammatory syndrome in children associated with COVID-19. A case report. Front Immunol 12:665824. https:\/\/doi.org\/10.3389\/fimmu.2021.665824","journal-title":"Front Immunol"},{"issue":"12","key":"609_CR10","doi-asserted-by":"publisher","first-page":"1582","DOI":"10.1111\/aor.14047","volume":"45","author":"L Steurer","year":"2021","unstructured":"Steurer L, Schlager G, Sadeghi K, Golej J, Wiedemann D, Hermon M (2021) Hemadsorption as rescue therapy for patients with multisystem organ failure in pediatric intensive care\u2014report of two cases reports and review of the literature. Artif Organs 45(12):1582\u20131593. https:\/\/doi.org\/10.1111\/aor.14047","journal-title":"Artif Organs"},{"issue":"12","key":"609_CR11","doi-asserted-by":"publisher","first-page":"e230","DOI":"10.1097\/MAT.0000000000001834","volume":"68","author":"WF Hui","year":"2022","unstructured":"Hui WF et al (2022) The sequential use of extracorporeal cytokine removal devices in an adolescent with COVID-19 receiving continuous renal replacement therapy. ASAIO J 68(12):e230\u2013e234. https:\/\/doi.org\/10.1097\/MAT.0000000000001834","journal-title":"ASAIO J"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00609-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-025-00609-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-025-00609-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T08:25:50Z","timestamp":1737707150000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-025-00609-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,24]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["609"],"URL":"https:\/\/doi.org\/10.1186\/s43044-025-00609-3","relation":{},"ISSN":["2090-911X"],"issn-type":[{"value":"2090-911X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,24]]},"assertion":[{"value":"23 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The present case report was reviewed and approved by the institutional ethics committee. Proper informed consent to participate was given.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The respective informed consent and authorization for publication of the case and images was duly completed by the patient\u2019s legal guardian. Approval from ethics committee was obtained prior to the submission of the main text. In case of being required the informed consent is given.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant financial or non-financial interests to disclose. No use of any AI or any large language model were used during the writing, processing or editing of the present manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"15"}}