Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report
Abstract Background Transcatheter valve replacement is contraindicated in patients with active infective endocarditis. However, few reports suggest that it could be beneficial for high-risk surgical patients with healed infective endocarditis. Here, we report a case of a surgical transcatheter aorti...
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Japan Surgical Society
2023-09-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-023-01739-z |
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| author | Yusuke Takei Ryujiro Suzuki Ikuko Shibasaki Michiaki Tokura Takahisa Nasuno Hiroko Yazawa Mayo Wada Fumiya Saito Shigeru Toyoda Hirotugu Fukuda |
| author_facet | Yusuke Takei Ryujiro Suzuki Ikuko Shibasaki Michiaki Tokura Takahisa Nasuno Hiroko Yazawa Mayo Wada Fumiya Saito Shigeru Toyoda Hirotugu Fukuda |
| author_sort | Yusuke Takei |
| collection | DOAJ |
| description | Abstract Background Transcatheter valve replacement is contraindicated in patients with active infective endocarditis. However, few reports suggest that it could be beneficial for high-risk surgical patients with healed infective endocarditis. Here, we report a case of a surgical transcatheter aortic valve in a patient with healed repeated prosthetic valve endocarditis using a stentless valve. Case presentation A 79-year-old female who underwent the Bentall procedure using a stentless valve and coronary artery bypass grafting for annuloaortic ectasia 22 years ago was hospitalized for stage II bioprosthetic valve failure. The patient had a history of prosthetic valve endocarditis three times: the first and second prosthetic valve endocarditis occurred 15 years ago, and the third prosthetic valve endocarditis occurred 3 years ago. The causative organisms were Campylobacter fetus and Enterococcus faecalis. With appropriate antibiotic therapy, the lesion was localized and healed completely without valve destruction; however, the patient developed rapid aortic regurgitation. Based on a review of the patient’s history of prosthetic valve endocarditis, the absence of signs of infection, and clinical findings of transesophageal echocardiography and computed tomography, a diagnosis of structural valve deterioration with healed infective endocarditis was made. Subsequently, a transcatheter aortic valve in a surgical aortic valve using a balloon-expandable type was performed, because the patient had a high surgical risk of 12.7%. The patient’s postoperative course was uneventful. At the 1-year follow-up, there were no signs of infection or valve abnormalities. Conclusions Transcatheter valve replacement can be a treatment option for high-risk surgical patients with healed limited lesions in infective endocarditis. |
| format | Article |
| id | doaj-art-7a748de2a0d741b39c0abedf2c23100d |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-7a748de2a0d741b39c0abedf2c23100d2025-08-20T02:52:12ZengJapan Surgical SocietySurgical Case Reports2198-77932023-09-01911810.1186/s40792-023-01739-zTranscatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case reportYusuke Takei0Ryujiro Suzuki1Ikuko Shibasaki2Michiaki Tokura3Takahisa Nasuno4Hiroko Yazawa5Mayo Wada6Fumiya Saito7Shigeru Toyoda8Hirotugu Fukuda9Department of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiovascular Medicine, Dokkyo Medical University Graduate School of MedicineDepartment of Cardiac and Vascular Surgery, Dokkyo Medical University Graduate School of MedicineAbstract Background Transcatheter valve replacement is contraindicated in patients with active infective endocarditis. However, few reports suggest that it could be beneficial for high-risk surgical patients with healed infective endocarditis. Here, we report a case of a surgical transcatheter aortic valve in a patient with healed repeated prosthetic valve endocarditis using a stentless valve. Case presentation A 79-year-old female who underwent the Bentall procedure using a stentless valve and coronary artery bypass grafting for annuloaortic ectasia 22 years ago was hospitalized for stage II bioprosthetic valve failure. The patient had a history of prosthetic valve endocarditis three times: the first and second prosthetic valve endocarditis occurred 15 years ago, and the third prosthetic valve endocarditis occurred 3 years ago. The causative organisms were Campylobacter fetus and Enterococcus faecalis. With appropriate antibiotic therapy, the lesion was localized and healed completely without valve destruction; however, the patient developed rapid aortic regurgitation. Based on a review of the patient’s history of prosthetic valve endocarditis, the absence of signs of infection, and clinical findings of transesophageal echocardiography and computed tomography, a diagnosis of structural valve deterioration with healed infective endocarditis was made. Subsequently, a transcatheter aortic valve in a surgical aortic valve using a balloon-expandable type was performed, because the patient had a high surgical risk of 12.7%. The patient’s postoperative course was uneventful. At the 1-year follow-up, there were no signs of infection or valve abnormalities. Conclusions Transcatheter valve replacement can be a treatment option for high-risk surgical patients with healed limited lesions in infective endocarditis.https://doi.org/10.1186/s40792-023-01739-zTranscatheter valve replacementTranscatheter aortic valve in a surgical aortic valveStentless valveProsthetic valve endocarditisHealed infective endocarditis |
| spellingShingle | Yusuke Takei Ryujiro Suzuki Ikuko Shibasaki Michiaki Tokura Takahisa Nasuno Hiroko Yazawa Mayo Wada Fumiya Saito Shigeru Toyoda Hirotugu Fukuda Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report Surgical Case Reports Transcatheter valve replacement Transcatheter aortic valve in a surgical aortic valve Stentless valve Prosthetic valve endocarditis Healed infective endocarditis |
| title | Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report |
| title_full | Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report |
| title_fullStr | Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report |
| title_full_unstemmed | Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report |
| title_short | Transcatheter aortic valve-in-surgical aortic valve for a patient with repeated healed endocarditis: a case report |
| title_sort | transcatheter aortic valve in surgical aortic valve for a patient with repeated healed endocarditis a case report |
| topic | Transcatheter valve replacement Transcatheter aortic valve in a surgical aortic valve Stentless valve Prosthetic valve endocarditis Healed infective endocarditis |
| url | https://doi.org/10.1186/s40792-023-01739-z |
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