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Prosthetic valve endocarditis caused by silent infection of methicillin-resistant coagulase-negative staphylococci

Kayo Sugiyama1, Hirotaka Watanuki2, Yasuhiro Futamura2

  • 1Department of Cardiac Surgery, Aichi Medical University, Nagakute, Aichi, Japan kayotaro3@gmail.com.

BMJ Case Reports
|January 26, 2021
PubMed

Insights

This study details a complex redo mitral valve replacement for prosthetic valve endocarditis, successfully using a reconstructed mitral annulus and a reinforced tissue valve. The findings highlight the challenge of detecting indolent methicillin-resistant coagulase-negative staphylococci (MRCNS) in such cases.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Biomaterials in Medicine

Background:

  • Prosthetic valve endocarditis in the mitral position presents significant surgical challenges.
  • Mitral annulus reconstruction is a viable option for infected annuli.

Observation:

  • A redo mitral valve replacement was performed using a collar-reinforced tissue valve.
  • The mitral annulus was reconstructed with a bovine patch.
  • Preoperative cultures identified Streptococcus anginosus, while intraoperative cultures revealed methicillin-resistant coagulase-negative staphylococci (MRCNS).

Findings:

  • Successful implantation of a reinforced tissue valve into a reconstructed mitral annulus.
  • The identification of MRCNS, an organism rarely detected due to its indolent nature, highlights diagnostic challenges.

Implications:

  • This case demonstrates a successful surgical strategy for complex prosthetic valve endocarditis.
  • Improved diagnostic methods for indolent pathogens like MRCNS are needed.
  • Bovine pericardial patches are effective for mitral annulus reconstruction in challenging cases.
Keywords:
heart failureinfectionsinfectious diseasessurgical diagnostic testsvalvar diseases

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