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Tricuspid valve repair for tricuspid valve endocarditis after Fallot repair
Y d'Udekem1, T Sluysmans, J E Rubay
1Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Insights
Early postoperative endocarditis after tetralogy of Fallot repair is rare. This case highlights tricuspid valve annulus abscess and leaflet dehiscence requiring surgical reconstruction.
Area of Science:
- Pediatric Cardiac Surgery
- Infectious Disease in Congenital Heart Disease
Background:
- Tetralogy of Fallot repair, while common, carries rare risks.
- Postoperative endocarditis can occur, particularly at prosthetic material sites.
Observation:
- A 1-year-old infant developed early postoperative endocarditis following tetralogy of Fallot repair.
- Reoperation revealed an abscess at the ventricular septal defect patch implantation site on the tricuspid valve annulus.
Findings:
- The abscess led to dehiscent septal and anterior tricuspid valve leaflets.
- Surgical reconstruction involved debridement, autologous pericardial patch repair of the annulus, and leaflet reimplantation.
Implications:
- This case underscores the importance of vigilance for rare complications like endocarditis after complex congenital heart surgery.
- Successful management involved aggressive debridement and reconstruction, preserving native valve function.
Abstract:
Occurrence of endocarditis after surgical repair of tetralogy of Fallot is rare. A case of early postoperative endocarditis in a 1-year-old infant is described. At reoperation an abscess of the the tricuspid valve annulus was discovered at the site of implantation of the ventricular septal defect patch. After debridement of the annulus, the septal and the anterior leaflet of the tricuspid valve were found dehiscent from their annular insertion. The tricuspid annulus was reconstructed with a patch of autologous pericardium, and the preserved leaflets were reimplanted.