Cytosorb® hemoadsorption of apixaban during emergent cardio-pulmonary bypass: a case report

Background: Peri-operative coagulation management of patients receiving apixaban, a new oral anticoagulant, is difficult. The CytoSorb® hemoadsorption device might represent a therapeutic option to reduce apixaban’s pharmacological and inflammatory effects during high-risk surgery. Case presentation: An 83-year-old woman treated with Apixaban underwent emergent redo mitral valve replacement for prosthetic valve endocarditis. A CytoSorb® cartridge was added to the cardio-pulmonary bypass (CPB) circuit. Apixaban-specific anti-factor Xa activity (AFXaA) were measured peri-operatively. After 100 minutes of CPB, a 50% AFXaA rate decrease was observed as compared to pre-CPB values. Furthermore, we noticed 39% and 44% reductions of AFXaA levels in comparison to the expected levels in patients with normal or altered renal function, respectively. Conclusion: Insertion of a CytoSorb® cartridge in the CPB was safe and associated with rapid correction of Apixaban-associated anticoagulation.

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An alternative approach for complicated prosthetic aortic valve endocarditis

Surgical Case Reports ◽

10.1186/s40792-021-01195-7 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Dimos Karangelis ◽

Argyris Krommydas ◽

Fotios A. Mitropoulos

Keyword(s):

Surgical Treatment ◽

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Pericardial Patch ◽

Safe Alternative ◽

Case Presentation ◽

Prosthetic Aortic Valve ◽

Alternative Approach ◽

Sutureless Valve ◽

Valve Implantation

Abstract Background Surgical treatment of prosthetic valve endocarditis (PVE) with destruction of the aortic root and aortomitral continuity is demanding even in experienced hands. Case presentation Herein, we describe a case of a 71-year-old female patient who presented with PVE that was further complicated by a fistulous abscess cavity. The patient underwent removal of the dehisced prosthetic valve, radical annular debridement, reconstruction of the aortomitral curtain with a pericardial patch as a patch exclusion technique and implantation of a sutureless valve. Conclusion Patch exclusion technique, followed by sutureless valve implantation, might represent a feasible and safe alternative for the surgical treatment of complicated PVE.

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Modified Commando Procedure in Complicated Infective Endocarditis - A Case Series.

10.21203/rs.3.rs-105185/v1 ◽

2020 ◽

Author(s):

Po Sung Chen ◽

Chungyi Chang ◽

Yicheng Chuang ◽

Ichen Chen ◽

Tingchao Lin

Keyword(s):

Infective Endocarditis ◽

Prosthetic Valve ◽

Case Series ◽

Prosthetic Valve Endocarditis ◽

Surgical Mortality ◽

Native Valve ◽

Case Presentation ◽

Native Valve Endocarditis ◽

Fibrous Body ◽

Urgent Surgery

Abstract Background: Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly. Case presentation: We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding. Conclusions: We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.

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Modified commando procedure in complicated infective endocarditis ─ a case series

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01480-4 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Posung Chen ◽

Chungyi Chang ◽

Yicheng Chuang ◽

Ichen Chen ◽

Tingchao Lin

Keyword(s):

Infective Endocarditis ◽

Prosthetic Valve ◽

Case Series ◽

Prosthetic Valve Endocarditis ◽

Surgical Mortality ◽

Native Valve ◽

Case Presentation ◽

Native Valve Endocarditis ◽

Fibrous Body ◽

Urgent Surgery

Abstract Background Complicated infective endocarditis (IE) with perivalvular abscess and destruction of intervalvular fibrous body (IFB) has high mortality risk and requires emergent or urgent surgery mostly. Case presentation We presented four patients with complicated infective endocarditis combined with perivalvular abscess and IFB destruction. Three patients had prosthetic valve endocarditis and one patient had native valve endocarditis. They all received modified Commando procedure successfully. No surgical mortality or re-exploration for bleeding. Conclusions We suggest that modified Commando procedure may have some benefit in improving survival rate of patients with complicated IE and reducing complications.

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A relapsed Pseudomonas stutzeri prosthetic valve endocarditis: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-021-03084-x ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Mayyadah Alabdely ◽

Mohammed Alazmah ◽

Bandar Alamro ◽

Mohamad S. Alabdaljabar ◽

Magid Halim

Keyword(s):

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Pseudomonas Stutzeri ◽

Opportunistic Pathogen ◽

Negative Bacterium ◽

Review Of The Literature ◽

Case Presentation ◽

Post Cardiac Surgery ◽

Medical Relevance ◽

Soil And Water

Abstract Background Pseudomonas stutzeri is a nonfluorescent denitrifying bacterium widely distributed in the environment, and it has also been isolated as an opportunistic pathogen from humans. It is a Gram-negative bacterium and a common inhabitant of soil and water. Case presentation We report the case of a 51-year-old arab gentleman who has systemic lupus erythematous complicated by lupus nephritis and underwent renal transplantation twice. He underwent mitral valve replacement and 4 years later was diagnosed with prosthetic valve endocarditis caused by Pseudomonas stutzeri. Conclusions Literature review was conducted and revealed that this pathogen may be of a particular medical relevance in immunocompromised patients. Our case proves that early infection and relapse despite optimal antibiotics course are possible outcomes of Pseudomonas stutzeri endocarditis. To the best of our knowledge, this is the second case of fulminant early prosthetic valve endocarditis occurring only 1 month post-cardiac surgery with relapse despite a complete antibiotics course.

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A case series of medically managed Candida Parapsilosis complex prosthetic valve endocarditis and literature review

10.21203/rs.3.rs-97836/v1 ◽

2020 ◽

Author(s):

Penghao Guo ◽

Yuting He ◽

Rui Fan ◽

Zhongwen Wu ◽

Yili Chen ◽

...

Keyword(s):

Prosthetic Valve ◽

Candida Parapsilosis ◽

Case Series ◽

Prosthetic Valve Endocarditis ◽

Sensu Stricto ◽

Therapeutic Strategies ◽

Case Presentation ◽

Candida Metapsilosis ◽

Candida Parapsilosis Complex ◽

Candida Orthopsilosis

Abstract Background: In recent years, Candida parapsilosis is recognized as a species complex and is composed of Candida parapsilosis sensu stricto, Candida orthopsilosis and Candida metapsilosis and Candida Parapsilosis complex prosthetic valve endocarditis (PVE) is rare and the survival rate is still low despite of optimal therapeutic strategies. Our paper is the first to report cases as Candida Parapsilosis complex PVE. Case presentation: A series of 4 cases of Candida Parapsilosis complex PVE from our institution was reported. Three were infected by Candida parapsilosis sensu stricto and one was infected by Candida metapsilosis. The condition of two cases got better and the other died. Conclusions: More attention should be paid to Candida Parapsilosis complex PVE and early diagnosis and prompt antibiotic therapy may play a role in the treatment for Candida Parapsilosis complex PVE

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