In: Journal of Cardiothoracic Surgery, 11 (2016), Nr. 100. S. 1-5. ISSN 1749-8090
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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.
Dokumententyp: | Artikel |
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Titel der Zeitschrift: | Journal of Cardiothoracic Surgery |
Band: | 11 |
Nummer: | 100 |
Verlag: | BioMed Central |
Ort der Veröffentlichung: | London |
Erstellungsdatum: | 20 Jul. 2016 11:11 |
Erscheinungsjahr: | 2016 |
ISSN: | 1749-8090 |
Seitenbereich: | S. 1-5 |
Institute/Einrichtungen: | Medizinische Fakultät Heidelberg und Uniklinikum > Medizinische Universitäts-Klinik und Poliklinik
Medizinische Fakultät Heidelberg und Uniklinikum > Chirurgische Universitätsklinik Medizinische Fakultät Heidelberg und Uniklinikum > Universitätsklinik für Anaesthesiologie Medizinische Fakultät Heidelberg und Uniklinikum > Department für Infektiologie Medizinische Fakultät Heidelberg und Uniklinikum > Pathologisches Institut |
DDC-Sachgruppe: | 610 Medizin |