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Treatment of prosthetic valve endocarditis by aortic valve neocuspidization using bovine pericardium

Yasunori Iida1, Kazuma Shimura1, Sho Akiyama1

  • 1Department of Cardiovascular Surgery, Ogikubo Hospital, Tokyo, Japan.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|November 3, 2017
PubMed

Insights

A 78-year-old man with a history of aortic valve replacement developed fever and neurological symptoms. He was successfully treated with aortic valve neocuspidization and antibiotics for infective endocarditis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Infective endocarditis is a serious complication following cardiac surgery.
  • Prosthetic valve endocarditis requires prompt diagnosis and management.
  • Cerebral infarction can be a manifestation of infective endocarditis.

Observation:

  • A 78-year-old male with prior aortic valve and ascending aorta replacement presented with fever and neurological deficits.
  • Blood cultures identified Gram-positive cocci, and imaging revealed cerebral infarction and a vegetation on the aortic valve.
  • Transesophageal echocardiogram confirmed a vegetation on the right coronary cusp.

Findings:

  • The patient underwent successful aortic valve neocuspidization using glutaraldehyde-treated bovine pericardium.
  • Postoperative treatment included 6 weeks of intravenous antibiotics.
  • Follow-up demonstrated no cardiac events and negative blood cultures.

Implications:

  • Aortic valve neocuspidization is a viable option for managing prosthetic valve endocarditis.
  • Early diagnosis and aggressive treatment are crucial for favorable outcomes.
  • This case highlights the importance of considering infective endocarditis in patients with prosthetic valves presenting with systemic symptoms.

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