Related Experiment Video
Updated: Jun 13, 2026
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Endocarditis with left ventricular cutaneous fistula after aortic root replacement with a valved conduit
Laura Hollinger1, Lynda Perryman, Michael J Reardon
1Department of Cardiac Surgery, The Methodist Hospital, Houston, Texas 77030, USA.
Texas Heart Institute Journal
|April 20, 2010
Summary
A rare, fatal complication of aortic root replacement occurred involving prosthetic valve endocarditis and a left ventricular fistula. This case highlights the critical surgical approach needed for such complex infections.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Medical Case Reports
Background:
- Aortic root replacement with a valved conduit and coronary reimplantation is a complex procedure.
- Infection following this surgery is uncommon but carries a high mortality risk.
Observation:
- A patient developed prosthetic valve endocarditis and a left ventricular cutaneous fistula after aortic root replacement.
- The fistula created a dangerous communication between the left ventricle, mediastinum, and the skin.
Findings:
- The patient presented with a rare and potentially fatal combination of prosthetic valve endocarditis and a left ventricular cutaneous fistula.
- The fistula's unique anatomical course posed significant surgical challenges.
Implications:
- This case underscores the importance of meticulous surgical technique and careful planning in managing complex post-aortic root replacement complications.
- Effective postoperative management is crucial for survival in patients with such severe infections and fistulas.
Keywords:
Anti-bacterial agents/therapeutic useaortic valve/surgerycardiac surgical procedures/adverse effects/epidemiology/etiologycutaneous fistula/etiology/surgeryendocarditis, bacterial/diagnosis/therapyheart valve prosthesis/microbiologyprosthesis-related infections/diagnosis/mortality/therapystaphylococcal infections/drug therapysurgical flapssurgical wound infection/complications/drug therapy/surgerytreatment outcome
Related Concept Videos
01:25Endocarditis I: Introduction
Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
01:18Endocarditis III: Medical Management
Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:25Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...