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Simultaneous Tricuspid and Pulmonic Valve Replacement Due to Infective Endocarditis
Erol Belli1, Luis Paulino2, Mohamed Khayata3
1Department of Cardiothoracic Surgery, University of South Florida Morsani College of Medicine, Tampa, USA.
Right-sided valvular infective endocarditis, a rare condition affecting both tricuspid and pulmonic valves, was treated surgically. Complications included heart block and ventricular tachycardia, managed with device implantation and exchange.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Right-sided valvular infective endocarditis (RSIE) commonly affects the tricuspid valve, often linked to intravenous drug abuse.
- Simultaneous involvement of both tricuspid and pulmonic valves in RSIE is exceptionally rare.
Observation:
- A 39-year-old female presented with symptoms including fever, dyspnea on exertion, and chest pain.
- Diagnostic evaluation revealed infectious endocarditis (IE) affecting both the tricuspid and pulmonic valves.
Findings:
- The patient underwent simultaneous tricuspid and pulmonic valvular repair using bioprosthetic valves and bovine pericardium.
- Post-operative recovery was complicated by complete atrioventricular (AV) block requiring pacemaker implantation.
- Further complications included ventricular tachycardia arrest, successfully managed by exchanging the initial pacemaker for a cardiac resynchronization therapy defibrillator.
Implications:
- This case highlights the challenges in managing rare RSIE involving multiple valves.
- Successful surgical intervention and advanced device management are crucial for favorable outcomes.
- The case underscores the importance of comprehensive management strategies for complex IE presentations and subsequent cardiac complications.
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