An alternative approach for complicated prosthetic aortic valve endocarditis.

Area of Science:

• Cardiovascular Surgery
• Infectious Diseases
• Prosthetic Valve Surgery

Background:

• Prosthetic valve endocarditis (PVE) poses significant surgical challenges, especially when involving the aortic root and aortomitral continuity.
• Destruction of these structures complicates surgical repair and increases patient risk.

Purpose of the Study:

• To describe a novel surgical approach for a complex case of PVE.
• To evaluate the feasibility and safety of a specific reconstructive technique for PVE with extensive destruction.

Main Methods:

• A 71-year-old female patient with PVE and a fistulous abscess cavity underwent surgical intervention.
• The procedure involved removal of the dehisced prosthetic valve, radical annular debridement, and reconstruction using a pericardial patch (patch exclusion technique).
• A sutureless valve was subsequently implanted.

Main Results:

• The described surgical technique successfully addressed the complex PVE with a fistulous abscess.
• The patient received a new valve following radical debridement and reconstruction of the aortomitral curtain.

Conclusions:

• The patch exclusion technique combined with sutureless valve implantation is a potentially feasible and safe surgical strategy.
• This approach may offer a viable alternative for managing complicated cases of prosthetic valve endocarditis.