scholarly journals Recurrent Multivalvular Staphylococcus Lugdunensis Endocarditis Causing Complete Heart Block after TAVR

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Preeti Singhal ◽  
Somsupha Kanjanauthai ◽  
Wilson Kwan
Keyword(s):  
Mitral Valve ◽  
Heart Block ◽  
Prosthetic Valve ◽  
Complete Heart Block ◽  
Severe Aortic Stenosis ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Insufficiency ◽  
Tricuspid Valve Repair ◽  
Staphylococcus Lugdunensis ◽  
Conduction Abnormalities

Prosthetic valve endocarditis after transcatheter aortic valve replacement (PVE after TAVR) is a feared complication most often observed during the early postprocedural period. We report a case of severe, multivalvular PVE after TAVR with complete heart block caused by an uncommon organism. A 78-year-old female with prior Streptococcus agalactiae mitral valve endocarditis treated with antibiotics presented one year later with severe, symptomatic aortic insufficiency. She subsequently underwent TAVR given high surgical risk. Six weeks post-TAVR, she presented with syncope, fever, and complete heart block. Transthoracic echocardiogram was not demonstrative of vegetation. Blood cultures were positive for Staphylococcus lugdunensis. Transesophageal echocardiogram (TEE) demonstrated vegetations of the aortic, mitral, and tricuspid valves and aorto-mitral continuity. While awaiting surgery, the patient developed cardiac arrest; she was resuscitated and taken to surgery emergently. The patient underwent TAVR explantation, bovine pericardial tissue aortic and porcine bioprosthetic mitral valve replacements, and tricuspid valve repair. Additionally, left main coronary artery endarterectomy was performed due to presence of infectious vegetative material. Staphylococcus lugdunensis is an unusual but virulent organism that may damage both native and prosthetic valves. Early surgery is recommended for PVE after TAVR, especially in cases with perivalvular disease causing conduction abnormalities. Learning Objectives. TAVR has revolutionized the management of severe aortic stenosis and has even been successfully utilized in select cases of aortic regurgitation. Unfortunately, there are a number of associated complications that can be difficult to diagnose, such as prosthetic valve endocarditis (PVE). We emphasize maintaining a high clinical suspicion for PVE after TAVR in patients presenting with conduction abnormalities and highlight the importance of early surgical management in cases complicated by heart block, abscesses, or destructive penetrating lesions.

scholarly journals Mitral valve m-mode echo in complete heart block with atrial tachycardia

Heart India ◽  
2013 ◽  
Vol 1 (3) ◽  
pp. 83
Author(s):  
Kalathingathodika Sajeer ◽  
Babu Kanjirakadavath ◽  
MangalathNarayanan Krishnan ◽  
Deepak Raju ◽  
MangalachulliPottammal Ranjith
Keyword(s):  
Mitral Valve ◽  
Heart Block ◽  
Atrial Tachycardia ◽  
Complete Heart Block

scholarly journals Left Ventricular Pseudoaneurysm Repair after Mitral Valve Re-replacement for Prosthetic Valve Endocarditis

2018 ◽  
Vol 47 (4) ◽  
pp. 166-169
Author(s):  
Daisuke Yano ◽  
Fumiaki Kuwabara ◽  
Shinji Yamada ◽  
Shinichi Ashida ◽  
Yuichi Hirate
Keyword(s):  
Mitral Valve ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm

scholarly journals 688. Incidence and Risk Factors for Prosthetic Valve Endocarditis Following TAVR: 2015-2019

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S446-S446
Author(s):  
Jamison Montes de Oca ◽  
Rachel Kenney ◽  
Janet F Wyman ◽  
Dee Dee Wang ◽  
Brian O'Neill ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Block ◽  
Prosthetic Valve ◽  
Diabetes Management ◽  
Significant Risk ◽  
Prosthetic Valve Endocarditis ◽  
Patient Characteristics ◽  
Bivariate Analysis ◽  
Transcatheter Aortic Valve ◽  
Henry Ford

Abstract Background Transcatheter aortic valve replacement (TAVR) is increasingly used for lower risk patients. Incidence of TAVR endocarditis ranges from 0.2% to 3.3%. The purpose of this study was to determine local incidence and risk factors of prosthetic valve infective endocarditis (PVIE) in a contemporary cohort. Methods IRB approved retrospective, nested case-control study evaluated the 1-year incidence and risk factors for PVIE among TAVR recipients from 2015 to 2019. Inclusion: ≥ 18 years, TAVR procedure at Henry Ford Health System. Exclusion: repeat TAVR. PVIE cases were matched with controls who did not experience PVIE. PVIE defined as diagnosis documentation in the electronic medical record. Figure 1. Study Design Results 23/1266 patients were identified as cases corresponding to a 1-year incidence of 1.82%. The median time to PVIE was 127 days and 35% occurred within 60 days. The most frequently isolated organisms were streptococci (26%), MRSA (13%), and MSSA (13%). Baseline demographics and comorbidities for 23 PVIE cases and 161 controls are displayed in Table 1. Significant risk factors for PVIE in bivariate analysis included STS-PROM (Society of Thoracic Surgeons Predicted Risk of Mortality), median: 4.1 controls and 6.4 cases (p = 0.012). Age, BMI, and comorbidities were not significantly different. Diabetes was notably more frequent among cases (36% vs 48%, p = 0.274). Patients with PVIE had more post-op RBC transfusions (5% vs 21.7% p = 0.003), ECG changes (23% vs 43.5%, p = 0.035), heart block (15.5% vs 34.8%, p = 0.038), longer length of stay (2 days, range 1 to 4 vs 4 to 11, p = 0.004), and thirty-day readmission (10.6% vs 52.2%, p < 0.001). Results displayed in Table 2. Table 1. Patient Characteristics and Risk Factor Analysis Table 2. Additional Outcomes Conclusion The results from this study give insight to the local incidence, microbiology, and risk of PVIE following TAVR. Future directions include a larger evaluation of modifiable risks such as diabetes management and examining the heart block patients who received permanent pacemaker implants. Disclosures Rachel Kenney, PharmD, Medtronic, Inc. (Other Financial or Material Support, spouse is an employee and shareholder) Janet F. Wyman, DNP, CNS-BC, FACC, Edwards Lifesciences (Consultant) Dee Dee Wang, MD, Edwards LifeSciences (Consultant) Brian O'Neill, MD, Edwards Lifesciences (Consultant)

scholarly journals Surgical Treatment of Atrial Fibrillation with Electhocautery during Mitral Valve Replacement

2016 ◽  
Vol 9 (1) ◽  
pp. 9-12
Author(s):  
Rampada Sarker ◽  
Manoz Kumar Sarker ◽  
Md Ataher Ali ◽  
Abdul Khaleleque Beg
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Block ◽  
Complete Heart Block ◽  
Pulmonary Veins ◽  
Maze Procedure ◽  
Number Of Patients

Background: The Maze procedure is the surgical treatment that can alleviate the three complications of atrial fibrillation- tachycardia, thrombo-embolism and hemodynamic compromise. We attempted ablation of atrial fibrillation with monopolar eletrocautery.Our objective was to evaluate the results of surgical treatment of atrial fibrillation by ablation of the left atrial wallaround the pulmonary veins with conventional electrocautery during mitral valve replacement.Methods:This retrospective observational study was carried out in the Department of Cardiac Surgery, National Institute of cardiovascular diseases, Dhaka, Bangladesh,from January 2014 to February 2016. Ablation of AF with monopolar electrocautery was done during mitral valve replacement. Recurrence of atrial fibrillation, any new arrhythmia, complete heart block, bleeding and perforation was noted during the operation and in postoperative period. Patients were followed up upto three months after the surgery.Results: All the Patients were free from atrial fibrillation after the procedure. At discharge 100 %, after I month 96.2% and after 3 months 92.3 % patient were free from atrial fibrillation. No patients developed complete heart block requiring pace maker and there was no incidence of atrial perforation at the sites of ablation.Conclusion: The surgical treatment of the atrial fibrillation with elcetrocautery during mitral valve replacement is able to reverse this arrhythmia in a significant number of patients during short term follow-up without any complication.Cardiovasc. j. 2016; 9(1): 9-12

scholarly journals Unicuspid Unicommissural Aortic Valve: An Extremely Rare Congenital Anomaly

2015 ◽  
Vol 42 (3) ◽  
pp. 273-276 ◽  
Author(s):  
Sukhjeet Singh ◽  
Puneet Ghayal ◽  
Atish Mathur ◽  
Margaret Mysliwiec ◽  
Constantinos Lovoulos ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Heart Block ◽  
Complete Heart Block ◽  
Severe Aortic Stenosis ◽  
Cardiac Computed Tomography ◽  
Permanent Pacemaker ◽  
Resonance Imaging ◽  
Rare Congenital Anomaly ◽  
3 Dimensional

Abstract Unicuspid aortic valve is a rare congenital malformation that usually presents in the 3rd to 5th decade of life—and usually with severe aortic stenosis or regurgitation. It often requires surgical correction. Diagnosis can be made with 2- or 3-dimensional transthoracic or transesophageal echocardiography, cardiac computed tomography, or cardiac magnetic resonance imaging. We report the case of a 31-year-old man who presented with dyspnea on exertion due to severe aortic stenosis secondary to a unicuspid unicommissural aortic valve. After aortic valve replacement, this patient experienced complete heart block that required the placement of a permanent pacemaker.

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