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Bacterial Endocarditis Manifesting as Outflow Tract Obstruction in Two Patients Implanted With Percutaneous

Nadia Chaudhry-Waterman1, Lisa Bergersen1, Jonathan Buber1

  • 1Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.

The Canadian Journal of Cardiology
|May 25, 2015
PubMed

Insights

Bacterial endocarditis can affect the periphery of transcatheter pulmonary valves, causing obstruction. This study presents two cases with differing disease courses, both successfully treated with catheterization procedures.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Devices

Background:

  • Transcatheter pulmonary valves are increasingly used, but bacterial infection is a concern.
  • Prosthetic valve endocarditis (PVE) is a serious complication.
  • Peripheral endocarditis is a rare presentation of PVE.

Observation:

  • Two patients with transcatheter pulmonary valves developed right ventricular outflow tract obstruction.
  • The obstruction was due to prosthetic pulmonary valve endocarditis involving the valve periphery.
  • One patient experienced acute, rapidly worsening symptoms, while the other had a chronic, slow-progressing condition.

Findings:

  • Peripheral endocarditis of transcatheter pulmonary valves is an uncommon but significant cause of obstruction.
  • The clinical presentation can vary from acute to chronic.
  • Catheterization procedures can effectively relieve the obstruction in the acute setting.

Implications:

  • Increased vigilance for peripheral endocarditis in patients with transcatheter pulmonary valves is warranted.
  • Early diagnosis and intervention are crucial for managing this complication.
  • Catheter-based interventions offer a viable treatment option for relieving obstruction.

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