Definitive cure of recurrent prosthetic endocarditis using silver-coated St. Jude Medical heart valves: a preliminary case report.
Despite progress in the area of antimicrobial treatment and the surgical use of homografts, prosthetic valve endocarditis (PVE) remains one of the most dangerous complications following heart valve replacement. We present the case of a patient treated for acute endocarditis which affected the mitral valve and who developed recurrent PVE and native aortic valve endocarditis. After multiple valve surgery, the infection was controlled following aortic and mitral valve replacement using silver-coated prostheses. The St. Jude Medical (SJM) mechanical heart valve Masters Series with Silzone coating is intended to protect heart valve patients against microbial infection. The Silzone coating is formed by an ion beam-assisted deposition process that incorporates silver into the sewing cuff of the SJM heart valve. It has also been suggested that silver treatment may improve the healing characteristics of the heart valve sewing cuff. This technology may be a valuable option to prevent or cure PVE, in addition to homografts. Although the present patient is an isolated case, it was encouraging to find not only a well-healed mitral valve silver-coated prosthesis but also no persistent or recurrent infection during a nine-month follow up.
Carrel
T
T
Clinic for Thoracic and Cardiovascular Surgery, University Hospital Berne, Switzerland. thierry.carrel@insel.ch
Nguyen
T
T
Kipfer
B
B
Althaus
U
U
D000328:Adult; D001021:Aortic Valve / Q000382:microbiology* / Q000601:surgery; D001672:Biocompatible Materials; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000601:surgery*; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D008943:Mitral Valve / Q000382:microbiology* / Q000601:surgery; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012834:Silver; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
D001672:Biocompatible Materials; D012834:Silver