[Bioprosthetic valve endocarditis associated with rapid progression of valvular stenosis;report of a case]

Long-term durability and stability of the hemodynamic performance of commercially available 2nd generation Carpentier-Edwards stented bovine pericardial aortic bioprostheses (Perimount valve) is reported based on echocardiographic follow-up examinations. Prosthetic valve deterioration of the Perimount valve usually occurs late and is age-dependent. We describe bioprosthetic valve deterioration of a Perimount valve with severe stenotic change 1 month postoperatively that developed in an infective endocarditis patient. Although preoperative echocardiography showed no signs of valve dehiscence or vegetation on the prosthesis, valve stenosis alone had progressed extremely rapidly during 2 weeks of febrile symptom. The valve leaflet was found at explant to be infiltrated with a cellular material fibrin other than bacteria or leukocytes. This rare occurrence needs to be reported in the literature to forewarn clinicians of an early manifestation of endocarditis that may not be recognized yet.