The role of transcatheter closure of the patent foramen ovale in the occurrence of various complications remains a controversial issue. Atrial arrhythmias and bleeding are common complications, while infectious complications are extremely rare. In this clinical case we would like to report a patient who underwent transcatheter closure of a patent foramen ovale complicated by subacute endocarditis of a fully endothelized device 5 years after surgery. A 49-year-old patient was admitted to the surgical department with diffuse chest pain, sweating and fever. Three weeks earlier the patient had a fever associated with a cold. The data of the general and biochemical blood analysis indicated the presence of an inflammatory reaction of the body. After transthoracic and transesophageal echocardiography, infective endocarditis was diagnosed. The patient underwent surgery as planned. After removal of the occluder and excision of the mitral valve cusps, implantation of a mechanical mitral valve prosthesis was performed. At the site of the removed occluder, the atrial septal defect was repaired with an autologous pericardial patch. Transesophageal echocardiography showed no residual blood flow through the interatrial septum. The postoperative period was uneventful. The patient was discharged in satisfactory condition 10 days after surgery. The total duration of the antibiotic therapy was 5 weeks. Key words: open oval window, infectious endocarditis, transcatheter closure of the defect.
Today, heart transplantation is a gold standard treatment of the terminal chronic heart failure. Despite the constant improvement of the technique of this operation and the emergence of new protocols of immunosuppressive therapy, one of the main problems in the development of heart transplantation in Ukraine is a limited donor pool. The article presents a clinical case of successful orthotopic heart transplantation, followed by mitral valve repair in the early postoperative period. Our experience shows that mitral valve repair after orthotopic heart transplantation provides good results in the medium term, and this type of intervention can potentially expand the donor pool, thus increasing the number of heart transplants. Key words: chronic heart failure, heart transplantation, mitral valve repair.
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