Prosthetic valve endocarditis with annulus destruction: technique for reconstruction

When endocarditis involves a mechanical prosthetic aortic valve, it is a certainty that the annulus is destroyed; the pathology may extend to produce aneurysms of the sinuses of Valsalva or progress to fistulization into juxtaposed cardiac chambers or the pericardium. Annular destruction breaks down the framework to which a new prosthesis is anchored; therefore, valve replacement requires the creation of a new annulus. This report describes the technique for reconstructing partial aortoventricular discontinuity caused by annular destruction from prosthetic valve bacterial endocarditis.