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Severe infective endocarditis after MitraClip implantation treated by cardiac surgery.
- Source :
-
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology [EuroIntervention] 2015 Jul; Vol. 11 (3), pp. 351-4. - Publication Year :
- 2015
-
Abstract
- Aims: To report the first described case of a mitral valve infective endocarditis (IE) post MitraClip®.<br />Methods and Results: An 88-year-old patient at high surgical risk (log. EuroSCORE 30.4%) underwent a MitraClip procedure for severe eccentric organic mitral regurgitation (MR) due to prolapse with a flail leaflet of the P2 segment (flail gap 6 mm). After one month, the patient was readmitted to our department for fever and recurrence of shortness of breath. An echocardiogram demonstrated severe MR recurrence due to ulceration in the region of the posterior leaflet despite good insertion of both clips, and a large vegetation of 1513 mm within the clip region. Blood cultures were positive for staphylococcus aureus. The patient was treated by cardiac surgery with mitral valve replacement due to IE despite a very high logistic EuroSCORE of 56.8%. Histological and bacteriological analysis of the clip devices confirmed active IE. After cardiac surgery, transthoracic echocardiography showed no mitral regurgitation and a mean gradient across the mitral valve bioprosthesis of about 5 mmHg. The patient was discharged to a rehabilitation department 15 days after cardiac surgery.<br />Conclusions: Surgical treatment as bail-out therapy for MR recurrence secondary to IE after MitraClip can be successfully carried out despite a high surgical risk.
- Subjects :
- Aged, 80 and over
Endocarditis diagnosis
Humans
Male
Mitral Valve Insufficiency surgery
Risk
Treatment Outcome
Cardiac Surgical Procedures adverse effects
Endocarditis microbiology
Heart Valve Prosthesis Implantation adverse effects
Mitral Valve surgery
Prosthesis-Related Infections microbiology
Staphylococcus aureus isolation & purification
Surgical Instruments microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 1969-6213
- Volume :
- 11
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 25136886
- Full Text :
- https://doi.org/10.4244/EIJY14M08_09