New Rocking Motion of a Prosthetic Aortic Valve: An Unexpected Echocardiographic Finding 1 Month After Implantation

Near‐complete aortic mechanical valve dehiscence due to endocarditis reinfection

“…Prosthetic valve IE is the most severe form of IE, accounting for 10%–30% of all IE cases. Overall, prosthetic valve IE has a mortality rate between 20% and 80% with reinfection of a prosthetic valve, especially with paravalvular involvement as in the presented case, associated with higher mortality and the increased need for repeat valve replacement . In the early postimplantation period (under 2 months), mechanical valve IE exceeds bioprosthetic valve IE.…”

“…In the early postimplantation period (under 2 months), mechanical valve IE exceeds bioprosthetic valve IE. However, by 5 years postimplantation, the IE rates between mechanical and bioprosthetic valves equalize …”

“…Hence, there may be a range of AI severity with the predictable severe AI findings associated with greater degrees of dehiscence. Other findings specific to prosthetic AV IE include mycotic aneurysm formation, paravalvular abscesses, and potential infectious spread to the anterior MV leaflet, mitral subvalvular apparatus, aorto‐mitral curtain, proximal aortic root, and left ventricular outflow tract (LVOT) . Echocardiography should also be used to evaluate for other IE‐engendered myocardial damage including ventricular septal defects and LVOT‐to‐right atrial or pulmonary artery fistula …”

“…aortic valve, endocarditis, infective endocarditis, prosthetic aortic valve, valve dehiscence case, associated with higher mortality and the increased need for repeat valve replacement. [1][2][3] In the early postimplantation period (under 2 months), mechanical valve IE exceeds bioprosthetic valve IE. However, by 5 years postimplantation, the IE rates between mechanical and bioprosthetic valves equalize.…”

“…However, by 5 years postimplantation, the IE rates between mechanical and bioprosthetic valves equalize. 1,3 Prosthetic AV IE occurs in 1%-6% of patients with a valve prosthesis. Prosthetic AV dehiscence is uncommon, reported in only 0.1%-1.3% of patients presenting for AV replacement.…”