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. 2021 May 26;7(1):131.
doi: 10.1186/s40792-021-01195-7.

An alternative approach for complicated prosthetic aortic valve endocarditis

Dimos Karangelis  1 , Argyris Krommydas  2 , Fotios A Mitropoulos  3
Affiliations

An alternative approach for complicated prosthetic aortic valve endocarditis

Dimos Karangelis et al. Surg Case Rep. .

Abstract

Background: Surgical treatment of prosthetic valve endocarditis (PVE) with destruction of the aortic root and aortomitral continuity is demanding even in experienced hands.

Case presentation: Herein, we describe a case of a 71-year-old female patient who presented with PVE that was further complicated by a fistulous abscess cavity. The patient underwent removal of the dehisced prosthetic valve, radical annular debridement, reconstruction of the aortomitral curtain with a pericardial patch as a patch exclusion technique and implantation of a sutureless valve.

Conclusion: Patch exclusion technique, followed by sutureless valve implantation, might represent a feasible and safe alternative for the surgical treatment of complicated PVE.

Keywords: Aortic valve replacement; Patch exclusion technique; Pericardial patch; Prosthetic valve endocarditis; Sutureless valve.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a Preoperative TEE short axis view. Blue arrows demarcate the large abscess cavity posteriorly. Blue chevron shows the vegetations in the right atrium. The severely calcified bioprosthesis is appreciated by the yellow arrow. RA: right atrium, LA: left atrium, RV: right ventricle. b Preoperative TEE long-axis view which shows the pseudoaneurysm formed by the ruptured abscess to the LVOT. c Postoperative TEE short axis view 2 years after surgery shows mild stenosis of the bioprosthetic aortic valve with no signs of abscess cavity or vegetations
Fig. 2
Fig. 2
a Aortic prosthesis is dehisced along the non-coronary annulus and there is separation of the aortomitral continuity with abscess cavity formation. b Pericardial patch used for reconstruction of the large aortomitral continuity defect. c Deployment of sutureless valve
See this image and copyright information in PMC

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