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. 2023 Nov 30;75(1):96.
doi: 10.1186/s43044-023-00421-x.

Native pulmonary valve massive endocarditis in a drug-addicted patients with Covid-19 pneumonia: a case report

Andrea Garatti  1 , Andrea Daprati  1 , Lorenzo Lora Ronco  1 , Carlo Gaetano Sassi  1 , Carlo De Vincentiis  1
Affiliations

Native pulmonary valve massive endocarditis in a drug-addicted patients with Covid-19 pneumonia: a case report

Andrea Garatti et al. Egypt Heart J. .

Abstract

Background: Pulmonary valve (PV) infective endocarditis is a rare pathology. Association between acute endocarditis and Covid pneumonia is equally poorly investigated.

Case presentation: We present the case of a 50-year-old male active drug-abuser admitted for native PV endocarditis with huge and mobile vegetations and a concomitant interstitial SARS-Cov2 pneumonia. Surgical timing was carefully evaluated, and the patient was first treated with Remdesivir to prevent ARDS evolution. After 5 days he underwent PV replacement with bioprosthesis via patch enlargement of RVOT and a tricuspid valve De-Vega annuloplasty. The postoperative course was uneventful with complete resolution of sepsis and viremia.

Conclusions: The association between infective endocarditis and Covid pneumonia is emerging in the recent months. The reorganization in cardiac surgery hub centers resulted in an increase of urgencies referral, with consequent relative observation of some pathologies (i.e., endocarditis). The widespread administration of antibiotics and corticosteroids during the first phase of the pandemic could have contributed to the development of a moderate immunodepression of the general population and, during the pandemic, patients have been reluctant to access to hospital care, and this diagnostic delay could contribute to misdiagnosis or late presentation. We believe that in the present case, the strategy of immediate viral and respiratory stabilization, followed by a timely surgical procedure, allowed an excellent outcome in a very complicated situation.

Keywords: Case report; Covid-19 pneumonia; Endocarditis; Pulmonary valve.

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Conflict of interest statement

The author(s) declare no competing interests.

Figures

Fig. 1
Fig. 1
A Transthoracic echocardiogram showing PV mass protruding in the RVOT. B Chest CT scan showing PV mass extending from the RVOT to the right pulmonary artery. C Chest CT scan showing interstitial pneumonia with ground-glass opacities and right lower pneumonia with confluent abscesses
Fig. 2
Fig. 2
A Intraoperative view, longitudinal incision of pulmonary trunk showing huge endocarditic mass on PV leaflets. B Intraoperative view, implanted pulmonary bioprosthesis with enlargement pericardial patch on RVOT and pulmonary trunk
See this image and copyright information in PMC

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