66yrs old, Male, presented to our hospital with history of low-grade fever of one month duration.Only significant past history psr-sx600 was right coronary artery (RCA)stenting done a year ago.Physical examination no localizing signs of fever.Blood culture identified pseudomonas aeruginosa.Electrocardiogram (ECG) showed old inferior wall myocardial infarction changes.
Echocardiography (ECHO) detected myocardial abscess along the right atrioventricular groove and vegetation on tricuspid valve.Coronary angiogram showed totally occluded and infected RCA stent with formation of coronary cameral fistula, draining into right atrium.A positron emission tomography (PET) scan and a computed rab bck-s4 tomography (CT) scan showed increased tracer uptake in RCA stent, peri-stent abscess.Infected stent, artery, and vegetation removed surgically, then graft given to distal RCA.The multi-diagnostic modality helped in identifying this condition early.
Timely surgical intervention helped the patient to recover in otherwise life-threatening complication.