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Isolated Tricuspid Valve Endocarditis Caused by Infection of an Implanted Central Venous Access Port Device

Shigeaki Aoyagi1, Takeshi Oda, Hayato Fukuda

  • 1Department of Cardiovascular Surgery, St. Mary's Hospital.

The Kurume Medical Journal
|March 4, 2016
PubMed

Insights

A central venous access port infection led to a severe tricuspid valve vegetation. Surgical repair successfully treated the infection and restored valve function.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Central venous access port infections can lead to serious complications.
  • Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings.
  • Tricuspid valve involvement secondary to bloodstream infections is a critical condition.

Observation:

  • A 70-year-old male presented with fever due to a pocket infection of a central venous access port, identified as MRSA.
  • Bloodstream infection resulted in a large vegetation on the posterior tricuspid leaflet, causing annular dilatation and severe regurgitation.
  • Despite 8 weeks of antibiotics, the infection persisted, necessitating surgical intervention.

Findings:

  • Surgical exploration revealed vegetations and torn chordae tendineae on the posterior tricuspid leaflet.
  • A successful bicuspidalization valvuloplasty with prosthetic ring annuloplasty was performed after resection of the affected leaflet.
  • The patient experienced no relapse of infection or residual regurgitation post-surgery.

Implications:

  • This case highlights the importance of early detection and management of central venous access port infections.
  • Tricuspid valve repair via bicuspidalization valvuloplasty is a viable option for complex infective endocarditis.
  • Aggressive surgical management can lead to favorable outcomes in persistent device-related infections affecting cardiac valves.

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