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Related Experiment Videos

Right sided infective endocarditis: tempus fugit!

Nico R Van de Veire1, An-Kristin Ascoop, Michel De Pauw

  • 1Department of Cardiovascular Diseases, Ghent University, Ghent, Belgium. nico.vandeveire@ugent.be

European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology
|June 1, 2005
PubMed
Summary

This case study highlights a patient with infective endocarditis and a tricuspid bioprosthesis who experienced a resolving mass after anticoagulation therapy. The findings suggest a potential role for anticoagulation in managing such complex cardiac conditions.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Intravenous drug use is a significant risk factor for infective endocarditis.
  • Tricuspid bioprosthetic valve endocarditis presents unique management challenges.
  • Mass formation on prosthetic valves can lead to severe hemodynamic compromise.

Observation:

  • A patient with a history of tricuspid bioprosthesis for infective endocarditis developed a large obstructing mass.
  • Hemocultures identified Enterococcus faecalis as the causative agent.
  • Initial treatment involved antibiotics, aspirin, and enoxaparin (anticoagulant).

Findings:

  • The prosthetic valve mass initially became mobile, increasing tricuspid regurgitation.
  • Over two weeks, the mass resolved spontaneously, and tricuspid insufficiency subsided.

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  • The patient became asymptomatic without surgical intervention.

    • Implications:

    • This case suggests a potential, albeit controversial, benefit of anticoagulation in managing prosthetic valve endocarditis with mass.
    • Conservative management with anticoagulation may be considered in select cases, potentially avoiding surgery.
    • Further research is warranted to clarify the role and safety of anticoagulation in infective endocarditis involving prosthetic valves.