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Tricuspid-valve repair for pacemaker leads endocarditis.
Federica Iezzi1, Roberto Cini, Paolo Sordini
1Division of Cardiac Surgery, Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy. federicaiezzi@hotmail.it
Permanent pacemakers can predispose non-addicted patients to tricuspid valve endocarditis. This case highlights a rare Staphylococcus hominis infection managed successfully with native valve repair, avoiding prosthetic risks.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Permanent pacemakers are recognized predisposing factors for tricuspid valve endocarditis in non-addicted individuals.
- Infective endocarditis (IE) poses significant risks, particularly rare causative agents like Staphylococcus hominis.
Observation:
- A 66-year-old male presented with pacemaker lead infection and native tricuspid valve endocarditis.
- The patient exhibited persistent, enlarging vegetation, severe tricuspid regurgitation, septic pulmonary emboli, and heart failure.
Findings:
- Staphylococcus hominis, a rare IE cause with high mortality, was identified.
- Surgical intervention was necessary due to the severity of the condition and complications.
- Native valve repair was chosen over prosthetic valve replacement to mitigate risks of prosthetic infection.
Implications:
- Successful native valve repair can be a viable alternative to prosthetic replacement in complex IE cases.
- Early recognition and management of pacemaker-associated IE are crucial for patient outcomes.
- This case underscores the importance of considering rare pathogens in infective endocarditis management.
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