[A case of DVR with Nicks's procedure for active infective endocarditis with periannular abscess]

We successfully performed DVR with aortic annular reconstruction by Nick's procedure for a case of active infective endocarditis (IE) with perianular abscess. The patient was 26-year-old woman, who suffered from acute AR and MR due to active IE. At operation, a bicuspid aortic valve was noted with scattered vegetations. The periannular abscess extended from the aortic annulus to the anterior mitral leaflet on which there was a leaflet aneurysm. The complete debridement of infected lesions resulted in the defect of aortic annulus at the area of the aorto-mitral fibrous continuity. We reconstructed the aortic annulus by the equine pericardial patch and performed DVR, followed by the reconstruction of the aortic root by Nicks's procedure. After the operation the antibiotics had been administrated to the patient until CRP became completely negative. The patient was discharged from our hospital at 59 POD with no evidence of recurrence of IE. In such cases, we acknowledge the importance of as much complete debridement of infected lesions as possible and regard Nicks's procedure useful as one of the options for reconstruction of aortic root after debridement.