ABSTRACT
Heart valve bioprostheses can undergo early post-implantation changes, including pannus and thrombus, which may be hastened by the presence of a left ventricular assist device (LVAD). We report the case of a 21 year-old male who was diagnosed with dilated cardiomyopathy and severe aortic insufficiency, and had his aortic valve replaced with a #25 BioPhysio valve (currently in clinical trials--Edwards Life Sciences, Irvine, CA, USA). His symptoms of congestive heart failure continued to worsen, and he received a Novacor LVAD (WorldHeart, Oakland, CA, USA), and subsequently, an orthotopic heart transplantation. The relevant pathologies of the heart, BioPhysio valve (in place for 4.5 months), and Novacor device are presented.
Subject(s)
Aortic Valve , Bioprosthesis , Heart Valve Prosthesis , Heart-Assist Devices , Prosthesis Implantation , Adult , Aortic Valve Insufficiency/complications , Aortic Valve Insufficiency/pathology , Aortic Valve Insufficiency/therapy , Cardiomyopathy, Dilated/complications , Cardiomyopathy, Dilated/pathology , Cardiomyopathy, Dilated/therapy , Device Removal , Equipment Failure Analysis , Heart Transplantation , Humans , Male , Mitral Valve Insufficiency/complications , Mitral Valve Insufficiency/pathology , Mitral Valve Insufficiency/therapyABSTRACT
Contemporary prosthetic heart valves (PHV) are a good mode of treatment of valvular heart disease. They last for an average of 5 to 10 years and bioprostheses fail due to the tissue degeneration. Infective endocarditis of the prosthetic valve is a relatively rare complication occurring in 0.5% to 1% of cases per year, and its late occurrence is even less common. Patients with PHV who undergo interventional or surgical procedures under adequate antibiotic coverage, infective endocarditis should not occur. We present a case of a 54-year-old woman who developed infective endocarditis on a porcine bioprosthesis, implanted 15 years earlier. The microorganism was Streptococcus viridans and the vegetations were surprisingly large and led to prosthesis obstruction.
