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Aspergillus prosthetic valve endocarditis
1Department of Cardiothoracic Surgery, Brook General Hospital, London, UK.
Summary
A rare fungal infection, Aspergillus fumigatus endocarditis, complicated a patient's aortic valve replacement. Despite treatment, the infection led to a pseudo-aneurysm and was deemed inoperable, highlighting a poor prognosis for such cases.
Area of Science:
- Cardiology
- Infectious Diseases
- Mycology
Background:
- A 66-year-old male underwent aortic valve replacement using a Carpentier Edwards xenograft.
- Nine months post-surgery, he developed Aspergillus fumigatus endocarditis and an aortic root abscess.
Observation:
- The aortic root was surgically replaced with an antibiotic-treated fresh homograft.
- Antifungal chemotherapy was initiated 24 hours after the homograft procedure.
Findings:
- One month later, a retrosternal pseudo-aneurysm of the ascending aorta developed.
- Re-operation revealed heavy fungal infection of the homograft, rendering the patient inoperable.
Implications:
- This case illustrates a rare but severe complication of cardiac valve prosthesis.
- The condition carries a very poor prognosis despite aggressive surgical and chemotherapeutic interventions.