Aortic Valve Replacement for Infective Endocarditis After Presternal Esophageal Reconstruction

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Infectious Diseases

Background:

• A 57-year-old male patient presented with dyspnea and was diagnosed with infective endocarditis affecting the aortic valve.
• The patient had a history of subtotal esophagectomy with neoesophageal reconstruction due to esophageal cancer six years prior.

Observation:

• The patient developed progressive heart failure and experienced multiple cerebral infarctions, necessitating urgent intervention.
• Aortic valve replacement was performed using a right thoracotomy approach.

Findings:

• The right thoracotomy approach provided a clear surgical view and successfully avoided injury to the patient's reconstructed esophagus.
• Emergency aortic valve replacement was completed effectively through this minimally invasive thoracic approach.

Implications:

• Right thoracotomy is a viable and beneficial surgical strategy for managing aortic infective endocarditis in patients with a history of esophageal reconstruction.
• This technique offers a safe alternative, minimizing risks associated with accessing the aortic valve in complex surgical histories.