Subject(s)
Aortic Valve Stenosis/surgery , Aortic Valve/diagnostic imaging , Bioprosthesis/adverse effects , Heart Valve Prosthesis/adverse effects , Transcatheter Aortic Valve Replacement/methods , Aged , Angiography , Aortic Valve/surgery , Aortic Valve Stenosis/diagnosis , Atrial Appendage , Female , Humans , Prosthesis Failure , ReoperationABSTRACT
Infective endocarditis is a rare but serious complication of pregnancy with high maternal and fetal mortality. Surgical intervention is an option when medical therapy fails. We report the case of a 23-year-old female with severe aortic valve regurgitation and hemodynamic compromise related to acute bacterial endocarditis of a congenital bicuspid aortic valve during the 23rd week of pregnancy. She underwent urgent aortic valve replacement and, despite implementation of known fetal-protection strategies, fetal demise occurred.
Subject(s)
Aortic Valve/abnormalities , Endocarditis, Bacterial/surgery , Heart Valve Prosthesis Implantation , Pregnancy Complications, Infectious/surgery , Streptococcal Infections/surgery , Adult , Aortic Valve/surgery , Aortic Valve Insufficiency/etiology , Aortic Valve Insufficiency/surgery , Endocarditis, Bacterial/complications , Endocarditis, Bacterial/diagnostic imaging , Female , Humans , Pregnancy , Streptococcal Infections/drug therapy , Streptococcus anginosus/isolation & purification , Ultrasonography , Viridans Streptococci/isolation & purificationABSTRACT
Traumatic injury to the retrohepatic veins continues to carry high mortality rates. In the last few decades various management strategies have been proposed. However, treatment of such injuries still remains highly variable and technically challenging due to the surgically inaccessible location of these vessels and the consequent difficulty controlling bleeding. We report a successful repair of complete transection of the two main extraparenchymal hepatic veins and laceration of the retrohepatic inferior vena cava using cardiopulmonary bypass (CPB) and hypothermic circulatory arrest (HCA) following blunt abdominal trauma. Immediate CPB with or without HCA can be life-saving and should be considered for patients with complex isolated retrohepatic venous injuries.