Late Postoperative Prosthetic Pulmonary Valve Endocarditis in a 13-Year-Old Girl with Repaired Tetralogy of Fallot

O’Brien, Morrough P.; Pourmoghadam, Kamal; DeCampli, William M.

doi:10.14503/thij-14-4130

Cited by 5 publications

(9 citation statements)

References 28 publications

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“…Despite this good survival, infective endocarditis (IE) is a growing complication in patients after PVR that can result in significant morbidity and mortality. Case reports and case series have reported that up to 56%‐65% of cases of IE after PVR require surgery after diagnosis, and the mortality is as high as 17% to 22% . In addition, some studies have suggested a higher risk for IE in patients following placement of a heterograft compared to homograft bioprosthetic pulmonary valve .…”

Section: Introductionmentioning

confidence: 99%

“…Case reports and case series have reported that up to 56%-65% of cases of IE after PVR require surgery after diagnosis, and the mortality is as high as 17% to 22%. [5][6][7] In addition, some studies have suggested a higher risk for IE in patients following placement of a heterograft compared to homograft bioprosthetic pulmonary valve. [8][9][10] With emerging data regarding the growing challenges of IE after PVR, the aim of the study was to evaluate the overall incidence, risk factors, and treatment outcomes for bioprosthetic pulmonary valve IE at our institution.…”

Section: Introductionmentioning

confidence: 99%

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Bioprosthetic pulmonary valve endocarditis: Incidence, risk factors, and clinical outcomes

Robichaud

Cohen

Woods

et al. 2018

Congenital Heart Disease

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bioprosthetic pulmonary valve endocarditis: Incidence, risk factors, and clinical outcomes

Robichaud

Cohen

Woods

et al. 2018

Congenital Heart Disease

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“…In this case, the identified microorganism was a gram positive bacterium: S. mitis . The most commonly identified organisms in previously described cases were Staphylococcus aureus , coagulase-negative staphylococcus and streptococcal species 3 , 4 , 6 . An upper respiratory tract infection (RTI) might have been the underlying cause for bacteraemia in this case, since S. mitis is an uncommon but known cause for RTI 8 , 9 and the patient later referred a short period of fever, with hoarseness and cough 1 month previous to the hospital admission.…”

Section: Discussionmentioning

confidence: 70%

“…Prosthetic valve endocarditis is a rare complication of valve replacement surgery with an incidence of 0.3–4.2% per patient-year, 1 , 2 and accounts for approximately 20% of all cases of infective endocarditis (IE) 3 . Most cases of prosthetic valve endocarditis regard adults with prosthetic aortic or mitral valve infections; reports of prosthetic pulmonary valve endocarditis (PVE) are rarely described outside major cohort reviews that usually focus on left-sided heart valves 4 . PVE has about 50 descriptions in worldwide literature, 4 but due to the increasing number of surgically corrected tetralogy of Fallot (TOF) patients (that often include pulmonary valve implantation) this scenario is likely to become more frequent, and the number of PVE has been rising, especially in percutaneously treated patients 2 .…”

Section: Introductionmentioning

confidence: 99%

“…Most cases of prosthetic valve endocarditis regard adults with prosthetic aortic or mitral valve infections; reports of prosthetic pulmonary valve endocarditis (PVE) are rarely described outside major cohort reviews that usually focus on left-sided heart valves 4 . PVE has about 50 descriptions in worldwide literature, 4 but due to the increasing number of surgically corrected tetralogy of Fallot (TOF) patients (that often include pulmonary valve implantation) this scenario is likely to become more frequent, and the number of PVE has been rising, especially in percutaneously treated patients 2 . It is associated with high morbidity and mortality, 5 and its diagnosis is challenging.…”

Section: Introductionmentioning

confidence: 99%

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A rare late finding in corrected tetralogy of Fallot: a case report

Sá

Guardado

Antunes

2018

European Heart Journal - Case Reports

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Introduction Isolated pulmonary valve endocarditis is a rare phenomenon. Pulmonary prosthesis endocarditis is even more unusual, with only about 50 descriptions in worldwide literature, and its diagnosis and treatment is a challenge. Due to the increasing number of surgically corrected tetralogy of Fallot (TOF) patients, that often include pulmonary valve implantation, this clinical scenario is likely to become more frequent. Case presentation We describe a 37-year-old man with a previously implanted biologic pulmonary prosthesis after a TOF correction that presented to the emergency department with new-onset fever, orthopnoea, and lower limb oedema. Blood cultures were positive for Streptococcus mitis . Transthoracic echocardiography showed a large mobile mass in the right ventricular outflow tract, apparently originating from the pulmonary prosthesis. Transoesophageal echocardiography (TOE) showed the presence of multiple mobile structures arising from the arterial surface of the prosthesis, extending into the right pulmonary artery and causing right ventricular obstruction. Antibiogram guided treatment was administered and surgery was performed, removing a 9 cm vegetation and replacing the valve. Patient recovered well and was discharged 35 days after. Discussion In right-sided endocarditis, surgery indications and its timing are much less clear than in left-sided infections, but current literature describes it as associated with a significant morbidity, mortality, and high likelihood of requiring surgery. Large vegetations and clinical signs of haemodynamic impact should prompt consideration of early surgical intervention. The combination of transthoracic and TOE allowed a correct diagnosis and a timely treatment.

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Prosthetic pulmonary valve and conduit endocarditis in congenital heart disease

Rebollal

Felipe-Abella

Gutiérrez-García

et al. 2019

Asian Cardiovasc Thorac Ann

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Background Pulmonary valve replacement is one of the most common procedures in patients with congenital heart disease. Little is known about prosthetic valve endocarditis in this population. Objectives To review management and outcomes of pediatric and adult patients with a prosthetic pulmonary valve or right ventricle-to-pulmonary artery conduit infective endocarditis. Methods and results A multiinstitutional cohort of 10 patients is reported. Median age at endocarditis was 24 years (range 8–41 years). The most common causative organisms were Staphylococcus ( n = 4) and Streptococcus species ( n = 2). In addition to medical treatment, 5 patients required surgery. Majors complications such as renal damage, life-threatening hemoptysis, and septic shock were observed. No patient died in hospital or during follow-up. Conclusions Pulmonary prosthetic valve endocarditis is a rare condition associated with significant morbidity and a high risk of requiring operative intervention. Larger studies are required to optimize the management.

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Late Postoperative Prosthetic Pulmonary Valve Endocarditis in a 13-Year-Old Girl with Repaired Tetralogy of Fallot

Cited by 5 publications

References 28 publications

Bioprosthetic pulmonary valve endocarditis: Incidence, risk factors, and clinical outcomes

Bioprosthetic pulmonary valve endocarditis: Incidence, risk factors, and clinical outcomes

A rare late finding in corrected tetralogy of Fallot: a case report

Prosthetic pulmonary valve and conduit endocarditis in congenital heart disease

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