[A case of secondary valve replacement caused by pulmonary bioprosthetic valve endocarditis]

A 42-year-old male with pulmonary bioprosthetic valve endocarditis accompanied by residual minor leakage through a previously closed patch for ventricular septal defect (VSD), underwent reoperation with a Carpentier-Edwards bioprosthetic valve. The patient had a history of pulmonary valve replacement and VSD in 1973. A massive vegetation on the pulmonary valve was demonstrated by echocardiography. Five repeated blood cultures yielded Eikenella corrodens. After medical treatment, reoperation was performed. The patient was free of complications after the procedure. Although bioprosthetic valves have potential problems of dysfunction and calcification in long-term use, these problems develop at a significantly slower rate in right-sided positions compared with left-sided positions and bioprosthetic valve thrombosis in the pulmonary position has apparently not been reported. Mechanical prostheses for pulmonary valve replacement have a poor prognosis, with a high incidence of valve thrombosis despite adequate anticoagulant therapy. For the replacement of prosthetic valves in right-sided positions (tricuspid and pulmonary), bioprosthetic valves are now our first choice.