title: Triple-valve treatment for prosthetic valve endocarditis occurring 20 years after implantation of a Carpentier-Edwards pericardial bioprosthesis in the aortic valve.
abstract: A 68-year-old woman had undergone aortic valve replacement and open commissurotomy 20 years previously. At the beginning of 2008, fever, cold, and heart failure symptoms were noted. On blood culture, Streptococcus oralis was detected three times. Surgery was performed under a diagnoses of prosthetic valve endocarditis in the aortic valve, mitral stenosis and insufficiency, and tricuspid insufficiency. Techniques consisted of additional aortic valve replacement, mitral valve replacement, and tricuspid annuloplasty. Vegetation was macroscopically and pathologically observed in the extirpated Carpentier-Edwards pericardial bioprosthesis that had been placed in the aortic valve. There was no postoperative recurrent inflammatory response. The patient was discharged 32 days after surgery.
authors.affiliation: Division of Cardiovascular Surgery, Sasebo City General Hospital, 9-3 Hirase, Sasebo, and Nagasaki University School of Medicine, Nagasaki, 857-8511, Japan. y-hisata@hospital.sasebo.nagasaki.jp
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hisata
authors.forename: Shiro
authors.initials: S
authors.lastname: Hazama
authors.forename: Kenta
authors.initials: K
authors.lastname: Izumi
authors.forename: Kiyoyuki
authors.initials: K
authors.lastname: Eishi
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects*; D004697:Endocarditis, Bacterial / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006351:Heart Valves / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008943:Mitral Valve / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000601:surgery; D010496:Pericardium / Q000637:transplantation*; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D012214:Rheumatic Heart Disease / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D019533:Streptococcus oralis / Q000302:isolation & purification; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery