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Case Reports
. 2016 Dec 1;43(6):514-516.
doi: 10.14503/THIJ-15-5354. eCollection 2016 Dec.

Tricuspid Valve Replacement in an HIV-Infected Patient with Severe Tricuspid Regurgitation Secondary to Remote Endocarditis

Merle Myerson, Ehrin J Armstrong, Eduard Poltavskiy, Jose Fefer, Heejung Bang
Case Reports

Tricuspid Valve Replacement in an HIV-Infected Patient with Severe Tricuspid Regurgitation Secondary to Remote Endocarditis

Merle Myerson et al. Tex Heart Inst J. .

Abstract

Surgical intervention for severe tricuspid regurgitation secondary to remote infective endocarditis has been infrequent, especially in patients also infected with the human immunodeficiency virus (HIV). We describe the case of a 62-year-old HIV-positive man, with a 24-year history of endocarditis caused by intravenous heroin use, who presented with severe tricuspid regurgitation. The patient was initially asymptomatic, was taking antiretroviral medications, and had a satisfactory CD4 count and an undetectable viral load, so we decided to manage the regurgitation conservatively. Two years later, he presented with biventricular heart failure and dyspnea. After surgical tricuspid valve replacement, his condition improved substantially. This case illustrates that HIV-infected patients with complex medical conditions can successfully undergo cardiac surgery.

Keywords: Disease management; HIV infections/complications; endocarditis, bacterial/physiopathology; heart valve diseases/complications/etiology/surgery/therapy; risk factors; treatment outcome; tricuspid valve/surgery.

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Figures

Fig. 1
Fig. 1
Preoperative transthoracic echocardiograms. A) Four-chamber view (color-flow Doppler mode) shows severe tricuspid regurgitation. B) Four-chamber view shows tricuspid valve (TV) remnants and marked right ventricular and right atrial dilation. RA = right atrium; RV = right ventricle
Fig. 2
Fig. 2
Postoperative transthoracic echocardiograms. A) Four-chamber view (color-flow Doppler mode) shows the bioprosthetic tricuspid valve (BTV) and less right atrial and right ventricular dilation. B) Four-chamber view shows improved right ventricular function. RA = right atrium; RV = right ventricle
See this image and copyright information in PMC

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