Prosthetic valve replacement in two cases with acute infective endocarditis

Ali Vefa Özcan, Ahmet Baltalarlı, İbrahim Gökşin, Gökhan Önem, Mustafa Saçar, Fahri Adalı

Pamukkale Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, Denizli

Two patients underwent prosthetic valve replacement for acute infective endocarditis. The presenting symptoms were high fever, fatigue, chest pain, and palpitation in both patients. Echocardiographic assessment showed mitral valve insufficiency with mitral valve vegetation, 12 mm in size, in the anterior leaflet in one patient (male, age 24 years), and mitral and aortic insufficiencies accompanied by vegetations on both valves in the other (female, age 22 years). The former patient responded to treatment with gentamicin and crystallized penicillin until the fourth week when high fever ensued. Following mechanical mitral valve replacement, no complications were seen within a six-month follow-up. The latter patient underwent emergency mitral and aortic valve replacement due to worsening clinical course after three days of medical treatment. However, she died at surgery due to low cardiac output despite intra-aortic balloon pump support.

Keywords : Endocarditis, bacterial/surgery; heart valve diseases/ surgery; heart valve prosthesis implantation

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