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Recurrent endocarditis in silver-coated heart valve prosthesis.
H K Kjaergard1, J Tingleff, U Abildgaard
1Department of Cardiothoracic Surgery, Gentofte Hospital, University of Copenhagen, Denmark.
The Journal of Heart Valve Disease
|May 4, 1999
Summary
A case study highlights recurrent prosthetic valve endocarditis (PVE) despite using a silver-coated mechanical valve. Further clinical trials are needed to assess the benefits of silver-coated prostheses for preventing PVE.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Biomaterials Science
Background:
- Prosthetic valve endocarditis (PVE) remains a significant risk following valve replacement surgery.
- Silver-coated sewing rings (Silzone) were introduced to mitigate peri- and postoperative microbial infection.
- The efficacy of silver-coated prostheses in preventing PVE requires further clinical evaluation.
Observation:
- A patient with aortic stenosis underwent mechanical valve replacement with a Silzone prosthesis.
- Early PVE developed, leading to reoperation and reimplantation of a second Silzone prosthesis, which also became infected.
- Subsequent operations involved homograft implantation and treatment for a pseudoaneurysm.
Findings:
- Prosthetic valve endocarditis was confirmed by clinical signs, echocardiography, and positive blood cultures for Staphylococcus epidermidis.
- Recurrent infections occurred despite the use of silver-coated valve prostheses.
- The patient required multiple reoperations, including homograft implantation.
Implications:
- This case underscores the persistent risk of endocarditis associated with prosthetic heart valves.
- The clinical benefit of silver-coated sewing rings in preventing PVE is not yet established.
- Further research and clinical trials are essential to validate the effectiveness of silver-coated prostheses in reducing PVE rates.