Surgical valve repair of isolated pulmonary valve endocarditis

Abstract

Isolated pulmonary valve endocarditis (IPE) is an uncommon clinical entity. We reported 4 cases of IPE without underlying heart diseases that required surgical interventions. Two of the present patients had predisposing factors that included a history of abdominal surgery in Case 1 and intravenous drug abuse in Case 3. All four patients presented with persistent fever together with pulmonary symptoms despite appropriate antibiotic management. Three of the patients underwent elective pulmonary valve repair, but Case 3 underwent an urgent surgical intervention due to uncontrolled septic shock. Pulmonary valve repair was performed using autologous pericardial patch in all 4 patients. All of them had immediate postoperative recovery and satisfactory outcomes in the follow-up.

Figure 1:

(A) Excised pulmonary leaflets with vegetations. (B) Exposition of the autologous pericardial leaflets.

Figure 2:

(A) CT imaging studies demonstrated bilateral pulmonary infiltrates that are comparable with pulmonary septic emboli (arrows). (B) Transthoracic echocardiography demonstrated a large, mobile pulmonary valve vegetation measuring 20 × 11 mm.