Infective Endocarditis Associated With Varicella Zoster Virus Following Aortic Valve Repair

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Biomaterials in Medicine

Background:

• Congenital bicuspid aortic valve is a common heart defect requiring surgical intervention.
• Neo-tricuspidization offers a potential reconstructive approach for aortic valve anomalies.
• CardioCel is a biomaterial used in cardiac tissue engineering.

Observation:

• Two pediatric patients with congenital bicuspid aortic valve underwent novel surgical procedures.
• One patient received CardioCel leaflets for neo-tricuspidization.
• The other patient had CardioCel grafted alongside a native leaflet.

Findings:

• Both patients experienced postoperative bacterial endocarditis.
• Varicella zoster virus infection was identified as a concurrent factor in endocarditis development.
• A second surgical procedure was required for both patients due to complications.

Implications:

• This case series highlights the potential complications, including endocarditis, following neo-tricuspidization for congenital bicuspid aortic valve.
• The association with varicella zoster virus warrants further investigation in immunocompromised patients undergoing cardiac surgery.
• Careful monitoring and management strategies are crucial for pediatric patients with complex aortic valve reconstructions.