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First experience with allogeneic homograft in the treatment of prosthetic endocarditis

Publication at Second Faculty of Medicine |
2011

Abstract

One of the possible complications after implantation of valve prostheses is the emergence of prosthetic endocarditis. It is a life-threatening complication, requiring complex and demanding treatment.

One of the possible therapeutic modalities is using of allogeneic homograft. In this case report, we describe the case of 54-year-old hypertensive patient with incidentally discovered, asymptomatic aortic regurgitation and dilatation of the ascending aorta.

We carried out planned replacement of the ascending aorta by a composite graft Bentall. The postoperative course was complicated by wound infection after sternotomy.

Despite maximized antibiotic therapy, prosthetic endocarditis with periprosthetic abscess formation developed. Based on repeated positive cultivation and positive CT fi ndings, reoperation was indicated, during which explanted composite graft was replaced by homograft.

The postoperative course was uncomplicated and the patient was discharged for home treatment in a good condition. Based on literature data and our own experience, we believe that the treatment of prosthetic aortic valve endocarditis by homograft could be the method of choice.