eprintid: 21486
rev_number: 15
eprint_status: archive
userid: 1589
dir: disk0/00/02/14/86
datestamp: 2016-07-20 11:11:29
lastmod: 2024-07-26 03:55:37
status_changed: 2016-07-20 11:11:29
type: article
metadata_visibility: show
creators_name: Borde, J. P.
creators_name: Sitaru, G.
creators_name: Kopp, W. H
creators_name: Ruhparwar, Arjang
creators_name: Ehlermann, Philipp
creators_name: Lasitschka, Felix
creators_name: Dalpke, Alexander
creators_name: Heininger, Alexandra
title: Heart transplantation as salvage therapy for progressive prosthetic valve endocarditis due to methicillin-resistant Staphylococcus epidermidis (MRSE)
subjects: ddc-610
divisions: i-910100
divisions: i-910200
divisions: i-910300
divisions: i-911700
divisions: i-912000
abstract: Background: Prosthetic valve endocarditis (PVE) has the highest in-hospital mortality among all cases of infective endocarditis (IE), it is estimated at about 40 %. Orthotopic heart transplantation (OHT) as a measure of last resort, may be considered in selected cases where repeated surgical procedures and conservative efforts have failed to eradicate persistent or recurrent IE. Only few clinical data are available regarding this rare indication for OHT, since active IE has traditionally been considered as a contraindication for OHT.   Case presentation: We report on a 55 year old male patient who underwent prosthetic valve replacement with a mechanical valved conduit ten years ago and developed now persistent PVE with severe complications due to methicillin-resistant Staphylococcus epidermidis (MRSE). Repeated surgical procedures and conservative efforts have failed to eradicate the pathogen. Regarding the lack of curative options, salvage OHT was discussed as a measure of last resort. 28 months after the first diagnosis of PVE, the patient was successfully transplanted and is now doing well under close follow-up (6 months post-OHT).   Conclusions: PVE remains a challenging condition regarding diagnosis and treatment. The presented case underscores the urgent need for an integrated and multidisciplinary approach to patients with suspected and definitive IE - especially in PVE. OHT might be a feasible measure of last resort in selected patients with IE. Our case report adds published clinical experience to this rarely performed procedure and consolidates previous findings.
date: 2016
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 165786605X
own_urn: urn:nbn:de:bsz:16-heidok-214864
language: eng
bibsort: BORDEJPHEARTTRANS2016
full_text_status: public
publication: Journal of Cardiothoracic Surgery
volume: 11
number: 100
place_of_pub: London
pagerange: 1-5
issn: 1749-8090
citation:   Borde, J. P. ; Sitaru, G. ; Kopp, W. H ; Ruhparwar, Arjang ; Ehlermann, Philipp ; Lasitschka, Felix ; Dalpke, Alexander ; Heininger, Alexandra  (2016) Heart transplantation as salvage therapy for progressive prosthetic valve endocarditis due to methicillin-resistant Staphylococcus epidermidis (MRSE).  Journal of Cardiothoracic Surgery, 11 (100).  pp. 1-5.  ISSN 1749-8090     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/21486/1/13019_2016_Article_505.pdf