title: Reconstruction of the fibrous trigone.
abstract: A 48-year-old man with a history of infective endocarditis and severe aortic regurgitation had undergone prosthetic aortic valve replacement at another institution. Two months later, the patient developed prosthetic valve endocarditis with an aortic root abscess and an aorto-left atrial periprosthetic valvular fistula through the detached posterior annulus of the mitral valve. We repaired the fistula by constructing a fibrous trigone made of bovine pericardium. We also replaced the prosthetic aortic valve with another prosthetic valve, while protecting the native mitral valve.
authors.affiliation: Department of Cardiopulmonary Transplantation, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Mehmet H
authors.initials: MH
authors.lastname: Akay
authors.forename: Magdalena Anna
authors.initials: MA
authors.lastname: Danch
authors.forename: William E
authors.initials: WE
authors.lastname: Cohn
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000038:Abscess / Q000382:microbiology / Q000601:surgery*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D002417:Cattle; D003646:Debridement; D020878:Device Removal; D004696:Endocarditis / Q000150:complications / Q000601:surgery*; D006349:Heart Valve Diseases / Q000382:microbiology / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation*; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000382:microbiology / Q000601:surgery*; D034363:Viridans Streptococci / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents