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Updated: Apr 17, 2026
12:17
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
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Prosthetic aortic valve: a bone in the system
Vitor Hugo Pereira1, Joana Guardado2, Marina Fernandes2
1Cardiology Department, Alto Ave Hospital Center, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.
Summary
A splenic abscess case revealed prosthetic valve endocarditis caused by Streptococcus milleri. A prior esophageal bone fragment removal was the likely infection source for this rare complication.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Case Report
Background:
- A 73-year-old female with a history of mechanical aortic valve replacement presented with a splenic abscess.
- The patient had a recent esophageal foreign body removal (bone fragment).
Observation:
- Transesophageal echocardiogram initially revealed multiple paravalvular abscesses, diagnosing prosthetic valve endocarditis.
- A follow-up echocardiogram showed a large pseudoaneurysm and significant periprosthetic regurgitation, necessitating cardiac surgery.
Findings:
- Microbiologic analysis identified Streptococcus milleri, a bacterium typically found in gastrointestinal flora, as the causative agent.
- The esophageal foreign body removal was identified as the probable portal of entry for the infective endocarditis.
Implications:
- This case highlights a rare presentation of infective endocarditis secondary to a gastrointestinal foreign body in a patient with a mechanical heart valve.
- It underscores the importance of considering unusual infection sources in patients with prosthetic material and endocarditis.
- Prompt diagnosis and surgical intervention are crucial for managing prosthetic valve endocarditis with severe complications like pseudoaneurysm and regurgitation.
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