title: Patch reconstruction of the mitral annulus for active infective endocarditis with annular abscess.
abstract: Active infective endocarditis is associated with high operative mortality and morbidity. The outcome may be improved by operating at the optimal time using the most appropriate surgical procedure. We describe a 15-year-old man with active infective endocarditis of the mitral valve associated with an annular abscess. Disseminated intravascular coagulation was associated with progressive decrease in the platelet count. The abscess was debrided, the mitral annulus was patch-reconstructed using bovine pericardium treated with glutaraldehyde, then the mitral valve was replaced. The patient was discharged from intensive care unit 3 days after operation with clinical and blood examination improvement. The patient is being observed carefully by periodic follow-up echocardiography, and there is no evidence of PVD, PVE or calcification of the patch during 14 months of follow-up period. Patch reconstruction of the annulus using bovine pericardium treated with glutaraldehyde reinforced the annulus and prevented local reinfection of the prosthesis in this patient.
authors.affiliation: First Department of Surgery, Kumamoto University School of Medicine, Kumamoto 860-8556, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kunitomo
authors.forename: M
authors.initials: M
authors.lastname: Hara
authors.forename: J
authors.initials: J
authors.lastname: Utoh
authors.forename: H
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: S
authors.initials: S
authors.lastname: Uemura
authors.forename: N
authors.initials: N
authors.lastname: Kitamura
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D019651:Plastic Surgery Procedures; D014463:Ultrasonography