Endocarditis in patients with ascending aortic prosthetic graft: a case series from a national multicentre registry

Ramos, António; García-Montero, Carlos; Moreno, A.; Muñóz, Patricia; Ruíz-Morales, Josefa; Sánchez-Espín, Gemma; Porras, Carlos; Sousa, Dolores; Corral, Laura Castelo; Fariñas, María del Carmen; Gutiérrez, Francisco; Reguera, J.M.; Plata, Antonio; Bouza, Emilio; Antorrena, Isabel; Alarcón, Arı́stides de; Pericás, José Manuel; Gurguí, M.; Rodríguez‐Abella, Hugo; Goenaga, Miguel Ángel; Oteo, José A.; García‐Pavía, Pablo

doi:10.1093/ejcts/ezw190

Cited by 18 publications

(25 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Endocarditis in patients with ascending aorta prosthetic graft is usually a late complication, with median time from initial surgery up to 24 months, and carries high mortality due to life-threatening complications such as heart failure, uncontrolled sepsis and aortic rupture. Current recommendation is surgical management, owing to high rates of reinfection when prosthetic endocarditis is managed with antibiotics alone 7. Our case is notable for an asymptomatic, delayed presentation of pseudoaneurysm formation, more than a decade after the infection of the prostheses that was managed medically.…”

Section: Discussionmentioning

confidence: 89%

Fortune or misfortune: asymptomatic, delayed presentation of complete dehiscence of mechanical aortic valve conduit and pseudoaneurysm

DeRose

Taub

2016

BMJ Case Reports

View full text Add to dashboard Cite

Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation is a rare complication following aortic root replacement. This complication often takes place in the setting of acute graft infection and accompanies symptoms of heart failure, valve insufficiency or sepsis. We present a delayed, asymptomatic presentation of this complication in a young man with distant history of aortic root replacement and medically treated prosthetic valve endocarditis a year postoperatively. He had been non-adherent to warfarin over 10 years, but otherwise maintained a healthy life. After being lost to follow-up, he re-presented 12 years after the initial operation with new-onset seizures. Echocardiogram revealed complete dehiscence of a composite valved conduit at the proximal anastomosis site with a resultant large pseudoaneurysm. The patient underwent an urgent re-operation with resection of the pseudoaneurysm and insertion of a tissue valved conduit. He had an uncomplicated postoperative recovery and promised close follow-up on discharge.

show abstract

Section: Discussionmentioning

confidence: 89%

Fortune or misfortune: asymptomatic, delayed presentation of complete dehiscence of mechanical aortic valve conduit and pseudoaneurysm

DeRose

Taub

2016

BMJ Case Reports

View full text Add to dashboard Cite

show abstract

“…(2009), обобщив отдаленные результаты протезирования аорты ксеноперикардиальным кондуитом, содержащим механический клапан, отметили развитие ИЭ, ставшего причиной смерти, у трех пациентов из 121 [6]. В группе, изученной Ramos A. et al (2016), из 3200 пациентов, страдавших доказанным ИЭ, 27 пациентов были носителями клапаносодержащих кондуитов [7]. По данным Monsefi N. et al (2014) ИЭ встречается с частотой 0,3% у лиц, Рисунок 5.…”

Section: Discussionunclassified

“…В литературе присутствуют сообщения о частом поражении внеклапанных структур, что также наблюдалось и в нашей практике. Ramos A. et al (2016) обнаружили околоклапанные абсцессы в 62,5% случаев ИЭ в этой группе [7]. Коллеги из Национального медицинского исследовательского центра сердечно-сосудистой хирургии им.…”

Section: Discussionunclassified

“…Бакулева наблюдали абсцессы корня аорты с деструкцией тканей и образованием свищей, медиастинит со свищами на переднюю грудную стенку [2, 3,4]. На сосудистый трансплантат инфекция, как правило, не распространяется [7]. У наших пациентов патологический процесс проявился развитием абсцесса корня аорты, парапротезной флегмоны, прорывами в правый желудочек, левое предсердие, отрывом протеза от кольца аорты.…”

Section: Discussionunclassified

See 1 more Smart Citation

Infectious endocarditis course after ascending aorta replacement with a valved conduit

Морова¹,

Цеханович²

2019

Arhivʺ vnutrennej mediciny

View full text Add to dashboard Cite

“…The presence of local complications, (such as periannular tissue destruction, abscess…) increases the complexity and mortality associated with IE surgery [2]. An episode of IE affecting a composite graft after aortic root replacement can be a life-threatening complication [3,4]. Moreover, redo procedures after a previous CAGB surgery, with a patent internal mammary artery (IMA), may significantly increase the risk of the surgical procedure [5].…”

Section: Introductionmentioning

confidence: 99%

Massive Bleeding After Median Sternotomy: Case Report of an Infrequent Complication of Infective Endocarditis

Barca¹

2017

AJCTS

View full text Add to dashboard Cite

We report an unusual complication of acute infective endocarditis, found in a 70 year-old man with a previous history of two cardiac surgery procedures. The first one was a full root replacement (Bentall-De Bono procedure), associated with three bypasses (one mammary and two vein grafts). The second procedure was a mitral valve replacement through a right thoracotomy ought to native mitral valve endocarditis. In the current admission, echocardiography showed a periaortic abscess (Figure 1) and severe prosthetic mitral valve insufficiency. CT scan showed a big collection in the anterior mediastinal space adjacent to the composite graft (Figure 2), which was suspected to be purulent material. A third surgical intervention was programmed despite the extreme surgical risk. During the median sternotomy, a massive bleeding occurred. It was originated in the mediastinal collection, which truly was a collection of contained bleeding, originated in the 10 yearsold anastomosis of the saphenous vein to the composite graft, which was completely detached due to endocarditic involvement of the aortic graft. The institution of cardiopulmonary bypass before sternal opening enabled the surgical team to maintain a stable hemodynamic situation and to continue the procedure satisfactorily.

show abstract

Endocarditis in patients with ascending aortic prosthetic graft: a case series from a national multicentre registry

Abstract: Most cases of endocarditis in patients with AAPG occur late after initial surgery. Mortality rate of patients with AAPG endocarditis who undergo surgery is acceptable. NYHA Class IV before surgery is associated with an increased postoperative mortality.

Cited by 18 publications

References 21 publications

Fortune or misfortune: asymptomatic, delayed presentation of complete dehiscence of mechanical aortic valve conduit and pseudoaneurysm

Fortune or misfortune: asymptomatic, delayed presentation of complete dehiscence of mechanical aortic valve conduit and pseudoaneurysm

Infectious endocarditis course after ascending aorta replacement with a valved conduit

Massive Bleeding After Median Sternotomy: Case Report of an Infrequent Complication of Infective Endocarditis

Contact Info

Product

Resources

About