Right-sided infective endocarditis accounts for 5–10% of endocarditis cases. It occurs predominantly among intravenous drug abusers. The pulmonary valve is involved in fewer than 2% of patients with endocarditis. Literature data are limited and optimal medical strategy, including surgical technique, remains non-standardized in this clinical situation. We present 2 patients treated surgically for tricuspid and pulmonary valve endocarditis and discuss a method of pulmonary valve neocuspidization based on the Ozaki technique.
Congenital heart disease (CHD) is one of the risk factors for developing infective endocarditis (IE). Right-sided IE occurs in 5%-10% of endocarditis cases, and pulmonary valve (PV) is involved in less than 2% of such patients. Literature data are few, and optimal treatment methods, indications for surgery, and types of operative techniques are still under debate. We present an adult patient with a rare combination of the ventricular septal defect (VSD) and PV IE who underwent surgical treatment. Neocuspidization with autologous pericardium was utilized for the reconstruction of his PV. We discuss details of this novel surgical technique.
The original Ozaki technique involves sizing and trimming the neovalve cusps during cross-clamp. It leads to prolongation of the ischaemic time, as compared to standard aortic valve replacement. We use preoperative computed tomography scanning of the patient's aortic root to develop personalized templates for each leaflet. With this method, autopericardial implants are prepared before the initiation of the bypass. It permits maximally adopting the procedure to the patient’s individual anatomy and to shorten the cross-clamp time. We present a case of a computed tomography-guided aortic valve neocuspidization and concomitant coronary artery bypass grafting with excellent short-term results. We discuss the feasibility and technical details of the novel technique.
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