Infective Endocarditis Involving a Bioprosthesis in the Aortic Valve Position with Operative Excision

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Infectious Diseases

Background:

• Prosthetic valve endocarditis (PVE) is a serious complication of cardiac valve replacement surgery.
• Bioprosthetic valves, while offering advantages, are susceptible to infection and degeneration over time.
• Understanding the reasons for bioprosthetic explantation is crucial for improving patient outcomes.

Purpose of the Study:

• To illustrate the diverse etiologies leading to the explantation of infected bioprosthetic devices.
• To present visual evidence through operative photographs of explanted infected bioprostheses.
• To analyze the clinical outcomes and surgical approaches in patients requiring bioprosthetic explantation due to infection.

Main Methods:

• Retrospective review of 15 cases with infected bioprostheses explanted over a period of 5 to 120 months.
• Detailed photographic documentation of the explanted bioprosthetic devices.
• Analysis of patient survival data, including short-term (≥30 days) and long-term (>1 year) postoperative survival.

Main Results:

• The study included 15 infected bioprostheses with a mean indwelling time of 42 months.
• Explantation was necessitated by a variety of factors, visually demonstrated through operative photographs.
• Postoperative survival rates were encouraging, with 11 patients surviving ≥30 days and 9 patients living longer than 1 year.

Conclusions:

• Infected bioprosthetic explantation is associated with variable causes and surgical techniques.
• Despite the challenges, a significant proportion of patients experience favorable long-term survival following explantation.
• Visual documentation aids in understanding the complex pathology and decision-making process in managing infected bioprostheses.