A rare case of infective endocarditis in a patient with BENTALL procedure

Introduction: Bentall procedure represents the repla-cement of the ascending aorta and aortic valve with a valvular conduct including the coronary ostia. This operation is performed in patients suffering aortic valve disease with ascending aorta aneurysm. The presen-ce of infective endocarditis on Bentall prosthesis repre-sents a rare complication cited in literature.

Methods: We present a case of a 53 year old patient with history of Bentall procedure for aortic bicuspid valve disease and ascending aortic aneurysm 7 years ago, admitted in the Infectious Disease Department for Staphylococcus aureus aortic valve prosthesis endo-carditis. Antibiotherapy was initiated and the patient transferred to Cardiology Department where compu-ted tomography showed aortic conduct endocarditis and 2 neoformation cavities. Completing antibiothera-py in the Infectious Disease Department, the case was cardiological reevaluated with surgical indication-Da-nielson procedure-replacing the infected conduct with totally biological conduct, with aorta-coronary ostia anastomoses by internal saphenous vein grafts. The evolution was favourable under anticoagulant and pla-telet antiaggregant therapy.

Results: Anticoagulation and antiaggregant therapy in patients with Danielson procedure is unclear due to a low number of cases in the literature. In addition, there are still debates on choosing the optimal therapy for in-fective endocarditis on Bentall.

Conclusions: Even though infective endocarditis in patients with Bentall procedure has a low incidence, it represents a serious complication. The therapeutic suc-cess depends on early diagnosis, targeted antibiotherapy, efficient antiaggregant/ anticoagulant therapy, op-timal prosthetic material and a good interdisciplinary collaboration.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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