A Perceval Valve in Active Infective Bioprosthetic Valve Endocarditis: Case Report

The case is presented of a 72-year-old male patient suffering from active infective aortic prosthetic endocarditis two months after emergency surgery with aortic valve implantation, and who underwent aortic arch reconstruction using a Dacron patch, due to the spontaneous post-procedural migration of a transcatheter-implanted aortic valve. The heart team considered transcatheter valve implantation (TAVI) due to the increased operative risk demonstrated by a EuroSCORE II of 10.9%, including chronic obstructive pulmonary disease (GOLD 3), cirrhosis (Child-B), esophageal varicose stage 2, chronic renal failure stage 3, and reduced left ventricular ejection fraction. Subsequently, the EuroSCORE II was extremely high (76%) due to active infective prosthetic endocarditis and the aortic arch reoperation. A sutureless aortic valve was implanted and a pericardial patch repair of the aortic ascending and arch completed. Sternal re-stabilization was required postoperatively. The patient was discharged home after 42 days, and no recurrent endocarditis was diagnosed during follow up.