title: Endocarditis of Amplatzer occluder devices after percutaneous closure of a mitral paravalvular leak.
abstract: Symptomatic paravalvular leaks (PVL) are a relatively uncommon, but potentially significant postoperative complication of valve replacement surgery. Percutaneous repair of PVLs has become an increasingly utilized approach in patients whose comorbidities obviate surgical repair. We present an interesting case of a gentleman who underwent successful repair of a mitral PVL with Amplatzer devices following initial aortic and mitral valve replacements for bacterial endocarditis. He later developed fungal endocarditis that ultimately required re-operation to remove the devices and replace his mitral and aortic valves. This complication of closure devices, although reportedly rare, should be considered when contemplating a percutaneous approach. © 2012 Wiley Periodicals, Inc.
authors.affiliation: Division of Cardiothoracic Surgery, University of Rochester/Strong Memorial Hospital, Rochester, New York 14624, USA. candice_lee@urmc.rochester.edu
authors.forename: Candice Y
authors.initials: CY
authors.lastname: Lee
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Ling
authors.forename: Peter A
authors.initials: PA
authors.lastname: Knight
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery; D002177:Candidiasis / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D020878:Device Removal; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery*; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D015641:Radiography, Interventional; D012086:Reoperation; D055989:Septal Occluder Device / Q000009:adverse effects*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents