Tricuspid and Aortic Valve and Ventricular Septal Defect Endocarditis: An Unusual Presentation of Acute Q Fever Sebastian Pagni, MD, Anthony Dempsey,

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Tricuspid and Aortic Valve and Ventricular Septal Defect Endocarditis: An Unusual Presentation of Acute Q Fever Sebastian Pagni, MD, Anthony Dempsey, MD, Erle H. Austin, MD The Annals of Thoracic Surgery Volume 88, Issue 6, Pages 2027-2029 (December 2009) DOI: 10.1016/j.athoracsur.2009.04.141 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A 4-chamber transesophageal echocardiographic view shows the involvement of the tricuspid valve and subvalvar apparatus. A large vegetation sits on the atrial side of anterior tricuspid leaflet (arrow). The Annals of Thoracic Surgery 2009 88, 2027-2029DOI: (10.1016/j.athoracsur.2009.04.141) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Right atrial exposure with a view of the large ventricular septal defect (arrow), anterior leaflet vegetation, and endocardial vegetations after removal of the septal and part of the anterior leaflet of the tricuspid valve (*). (B) Tricuspid valve specimen shows multiple vegetations involving the leaflets, cordi, and septal papillary muscle. The Annals of Thoracic Surgery 2009 88, 2027-2029DOI: (10.1016/j.athoracsur.2009.04.141) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions