[A case of radical operation for right-sided infective endocarditis due to Pseudomonas aeruginosa concurrent with VSD in the elderly person]

The case is a 60-year-old male. He was seen at this department because of a slight fever of less than 37.5 degrees C from half a year earlier. Echocardiography revealed vegetations under the tricuspid valve and pulmonary valve, and on scintigraphy of the pulmonary blood flow he was diagnosed with multiple pulmonary infarction. Causative bacteria were not identified by blood culture on admission. As the intraoperative findings, vegetations were seen attached to the area from the septal cusp to the anterior cusp in the tricuspid valve. With the pulmonary valve, a part of the valvular cusp was perforated. After closing VSD with a patch, the vegetations attached to the valvular cusps were excised and the tricuspid valve was reconstructed. As for the pulmonary valve, valve replacement was performed because of the destructive degeneration of the valvular cusp. Pseudomonas aeruginosa was detected on culture of the tissue of the valvular cusp resected during operation. Post operative course was uneventful. The patient was discharged on the 21st postoperative day.