[A case of successful redo-operation for active prosthetic valve endocarditis after modified Bentall operation]

A redo-operation for active prosthetic valve endocarditis after modified Bentall operation is reported. A 42-year-old man associated with Marfan syndrome was transferred to our hospital with complaints of high fever and general fatigue. A modified Bentall operation for acute aortic dissection was done five years ago. The aortic arch and descending thoracic aorta were replaced with prosthetic graft because of aneurysmal dilatation four years ago. Transesophagial echogram revealed a developing vegetation below the prosthetic valve and at the left ventricular outflow. A redo-operation of translocation method with Pieler method for coronary reconstruction was performed using a prosthetic valve of SJM 21 mm in size. After operation, hemolysis suddenly appeared and hepatic dysfunction gradually progressed. Reoperation was necessary for the redo-operation and and a SJM 21 mm valve was replaced with a new 25 mm SJM valve interposed between the graft. Hemolysis was immediately improved. A redo operation of translocation method with Pieler method for coronary reconstruction showed a good results.