A Case of Double Valve Replacement due to Prosthetic Valve Dysfunction after Infective Endocarditis
10.4326/jjcvs.42.163
- VernacularTitle:弁膜症術後の感染性心内膜炎発症2年後に生じた弁機能不全に対する1手術例
- Author:
Akihito Kagoshima
;
Shoichi Takahashi
- Publication Type:Journal Article
- Keywords:
valve obstruction;
pannus;
infective endocarditis;
multi detecter computed tomography
- From:Japanese Journal of Cardiovascular Surgery
2013;42(2):163-167
- CountryJapan
- Language:Japanese
-
Abstract:
A 56-year-old woman was admitted due to a cerebral hemorrhage two years after undergoing aortic valve replacement, mitral valve annuloplasty, and tricuspid valve annuloplasty. During treatment, she developed infective endocarditis. Although this was successfully treated conservatively, a surgical approach was subsequently adopted due to progressive mitral stenosis. Echocardiography revealed gradual proliferation of abnormal tissue overhanging the mitral valve around the prosthetic mitral annularring, as well as increased flow velocity in the artificial aortic valve. The cause of the increased flow velocity could not be determined on echocardiography. However, multidetector computed tomography revealed abnormal subprosthetic tissue that obstructed the opening and closing of the prosthetic aortic valve. Resection of the abnormal tissue and double valve replacement were performed. Prosthetic valve dysfunction due to pannus proliferation is relatively rare (around 1-2%), but it should be considered as a potential long-term postoperative complication. Though turbulent flow has been suggested as a potential cause, the exact etiology remains unknown. Furthermore, the disease course may be fulminant or gradual and symptomatic, leading to difficulties with diagnosis. A case of double valve replacement conducted for valve dysfunction due to abnormal tissue proliferation occurring two years after aortic valve replacement, mitral valve annuloplasty, and tricuspid valve annuloplasty followed by infective endocarditis is reported, along with a review of the related literature.
