title: [Redo Aortic and Mitral Valve Replacement by Manouguian's Procedure for Active Prosthetic Valve Infection].
abstract: The damage to the intervalvular fibrous trigone (IVFT) by infective endocarditis makes combined aortic and mitral valve replacement difficult. We performed Manouguian's double valve replacement for such a case and obtained a good result. A 81-year-old male underwent emergency operation due to active prosthetic valve endocarditis. He had a history of receiving combined aortic and mitral valve replacement because of active infective endocarditis at the age of 74 and redo aortic valve replacement 3 years after that. The infectious lesion extended from the mitral annulus to the IVFT and the aortic annulus, and it caused the prosthetic valve detachment from the aortic annulus. Manouguian's double valve replacement was required for radical resection and reconstruction of the IVFT. No recurrent infection or paravalvular leakage was observed during 49months follow up period. Manouguian's procedure is useful for complete resection of the infected IVFT and makes combined aortic and mitral valve replacement safer.
authors.affiliation: Department of Cardiac Surgery, International University of Health and Welfare Hospital, Nasushiobara, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kunitomo
authors.forename: Ken
authors.initials: K
authors.lastname: Okamoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Moriyama
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Tazume
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshinaga
authors.forename: Michio
authors.initials: M
authors.lastname: Kawasuji
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation