Reconstruction of the fibrous trigone

Tex Heart Inst J. 2009;36(5):475-6.

Abstract

A 48-year-old man with a history of infective endocarditis and severe aortic regurgitation had undergone prosthetic aortic valve replacement at another institution. Two months later, the patient developed prosthetic valve endocarditis with an aortic root abscess and an aorto-left atrial periprosthetic valvular fistula through the detached posterior annulus of the mitral valve. We repaired the fistula by constructing a fibrous trigone made of bovine pericardium. We also replaced the prosthetic aortic valve with another prosthetic valve, while protecting the native mitral valve.

Keywords: Aortic valve replacement; endocarditis/complications/surgery; fistula/etiology/surgery; heart valve prosthesis/adverse effects; mitral valve repair; prosthesis-related infections; reoperation.

Publication types

  • Case Reports

MeSH terms

  • Abscess / microbiology
  • Abscess / surgery*
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / surgery*
  • Cattle
  • Debridement
  • Device Removal
  • Endocarditis / complications
  • Endocarditis / surgery*
  • Heart Valve Diseases / microbiology
  • Heart Valve Diseases / surgery*
  • Heart Valve Prosthesis / adverse effects*
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / instrumentation
  • Humans
  • Male
  • Middle Aged
  • Pericardium / transplantation*
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery*
  • Reoperation
  • Severity of Illness Index
  • Treatment Outcome
  • Vascular Fistula / microbiology
  • Vascular Fistula / surgery*
  • Viridans Streptococci / isolation & purification

Substances

  • Anti-Bacterial Agents