Document Detail


Echocardiographic correlates of Freestyle stentless tissue aortic valve endocarditis.
MedLine Citation:
PMID:  11805959     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Echocardiography plays a critical role in assessing prosthetic valve endocarditis. Because normal paravalvular findings can mimic paraprosthetic infection early after implantation of a stentless bioprosthesis, we sought to define echocardiographic characteristics associated with infective endocarditis (IE) complicating stentless tissue aortic valve replacement. Between September 1992 and October 2000, 388 patients underwent aortic valve replacement with a Freestyle stentless tissue aortic valve. Nine patients presented with clinical endocarditis 10 days to 107 weeks after surgery. Patients included 8 men and 1 woman, ages 38 to 72 years. Of these, 7 patients underwent valve explantation, 1 patient was treated medically, and 1 died within hours of presentation. Intraoperative post-pump transesophageal echocardiography (TEE) and subsequent TEE examinations were reviewed for pertinent findings. For comparison, 22 patients without IE who underwent follow-up TEE within 1 year after Freestyle aortic valve replacement served as a control group. Abnormal TEE findings in patients with IE included new or worsening paravalvular aortic regurgitation (AR) in 4, diffuse leaflet thickening in 4, valvular vegetations in 1, and aorto-atrial fistula in 1. A progressive increase in the paravalvular echo-dense and/or echo-lucent space occurred in 5 of 9 patients. Among control subjects, paravalvular findings observed on immediate post-pump TEE resolved over time, and did not increase in size in any patient. In addition, no control patient developed new or progressive AR, diffuse leaflet thickening, or vegetations. TEE is useful in detecting valvular and paravalvular involvement of IE complicating stentless tissue aortic valve replacement. Because incremental change in paravalvular appearance from post-pump TEE is an important finding, intraoperative post-pump TEE should be performed and recorded in all patients undergoing stentless tissue aortic valve replacement.
Authors:
K Strelich; G M Deeb; D S Bach
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in thoracic and cardiovascular surgery     Volume:  13     ISSN:  1043-0679     ISO Abbreviation:  Semin. Thorac. Cardiovasc. Surg.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2002-01-23     Completed Date:  2002-03-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8917640     Medline TA:  Semin Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  113-9     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company
Affiliation:
Department of Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI 48109, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Valve / microbiology,  ultrasonography*
Bioprosthesis / microbiology*
Candida albicans / isolation & purification
Candidiasis / ultrasonography*
Echocardiography, Transesophageal
Endocarditis, Bacterial / microbiology,  ultrasonography*
Female
Heart Valve Prosthesis / microbiology*
Humans
Male
Middle Aged
Postoperative Complications / microbiology,  ultrasonography*
Prosthesis Design
Retrospective Studies
Staphylococcal Infections / ultrasonography*
Staphylococcus / isolation & purification

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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