A Case of Prosthetic Infective Endocarditis with Acute Myocardial Infarction due to Septic Embolism

Abstract

The patient was a 68-year-old man. In January 2017, he underwent aortic valve replacement Carpentier-Edwards Perimount Magna, 25 mm, Edwards Lifescience Corporation, Irvine, USA for aortic stenosis and coronary bypass surgery with two saphenous vein grafts SVG #7 and SVG-4PD for asymptomatic myocardial ischemia. He was treated as an outpatient by a local physician for at least a week during November 2017, with a principal complaint of mild fever, but no other significant symptoms. Transthoracic echocardiography suggested prosthetic valve endocarditis, so he was referred to the author s hospital. The day after admission, he had symptoms of thoracic discomfort, and emergency cardiac catheter examination showed a lesion thought to be due to a thrombus in the left main coronary trunk ; so, thrombus aspiration was carried out. However, no improvement in blood flow was achieved, so balloon angioplasty was carried out, with the aim of improving blood flow in the left circumflex artery, where coronary artery bypass grafting had not been performed. Improvement in blood flow was achieved, and a culture was carried out using the aspirated thrombus. Streptococcus pasteurianus was detected in the culture.