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Conservative surgery in multiple cusp involvement in tricuspid valve endocarditis
J R Anderson1, P Scott, R U Nair
1Killingbeck Hospital, Leeds.
British Heart Journal
|September 1, 1991
Summary
This case study details a novel surgical technique for severe tricuspid valve endocarditis. Autologous pericardial reconstruction of all three cusps was successfully performed after vegetation excision.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Staphylococcus epidermidis endocarditis can affect native valves.
- Native valve endocarditis in non-drug users is rare.
- Bi-ventricular failure and pulmonary emboli are severe complications.
Observation:
- A 57-year-old man presented with bi-ventricular failure and pulmonary emboli due to Staphylococcus epidermidis endocarditis affecting the tricuspid and mitral valves.
- Initial treatment involved intravenous antibiotics and serial echocardiography.
- Surgical intervention included mitral valve replacement and tricuspid valve cusp reconstruction.
Findings:
- Vegetations were excised from all three cusps of the tricuspid valve.
- Autologous pericardium was used to reconstruct the excised tricuspid valve cusps.
- Perioperative transoesophageal echocardiography confirmed excellent postoperative cardiac function and satisfactory tricuspid valve function.
Implications:
- This represents the first reported case of complete autologous pericardial reconstruction of all three tricuspid valve cusps after endocarditis.
- This technique offers a potential alternative for managing complex tricuspid valve endocarditis.
- Further research is warranted to evaluate the long-term efficacy and durability of this reconstructive approach.