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Case Reports
. 2015 May 25:8:111-6.
doi: 10.2147/IMCRJ.S61348. eCollection 2015.

Unusual mechanism of myocardial infarction in prosthetic valve endocarditis

Fernando A Atik  1 , Vanessa G Campos  2 , Claudio R da Cunha  1 , Felipe Bezerra Martins de Oliveira  1 , Maria Estefânia Bosco Otto  2 , Guilherme U Monte  2
Affiliations
Case Reports

Unusual mechanism of myocardial infarction in prosthetic valve endocarditis

Fernando A Atik et al. Int Med Case Rep J. .

Abstract

A 46-year-old man with bicuspid aortic valve and severe calcific aortic stenosis was submitted to aortic valve replacement with a stented bioprosthesis. He developed Staphylococcus epidermidis prosthetic valve endocarditis a month later, presenting in the emergency room with acute myocardial infarction. The mechanism of myocardial ischemia was a large aortic root abscess causing left main extrinsic compression. He was urgently taken to the operating room, and an aortic root replacement with cryopreserved homograft was performed, associated with autologous pericardium patch closure of aortic to right atrium fistula and coronary artery bypass grafting of the left anterior descending. After a difficult postoperative period with multiple problems, he was eventually discharged home. At 36-month follow-up, he is asymptomatic with no recurrent infection, and the left main coronary artery is widely patent on control chest computed tomography.

Keywords: allograft; aortic root; aortic valve replacement; endocarditis; heart valve.

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Figures

Figure 1
Figure 1
Admitting electrocardiogram.
Figure 2
Figure 2
Coronary angiogram and chest computed tomography. Notes: Coronary angiogram (A) in right anterior oblique showing a complex obstruction of the left main coronary artery. Chest computed tomography (B) showing a long obstruction of the left main coronary artery due to extrinsic compression. Abbreviation: LAD, left anterior descending.
Figure 3
Figure 3
Late postoperative chest computed tomography revealed a patent left coronary artery after homograft root replacement.
See this image and copyright information in PMC

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