Obstruction of mechanical valve prosthesis is a rarely seen but serious complication. Prosthetic valve thrombosis, pannus formation and vegetation are leading causes of an obstructed mechanical valve prosthesis. We report a surgically treated case of haemoculture negative valve endocarditis with an obstructed mitral valve prosthesis by a huge vegetation and pannus formation. A 36-year-old male patient, who underwent an aortic and mitral valve replacement operation two years ago, was admitted to our institution with dyspnea, orthopnea, tachypnea, tachycardia and fever. Physical examination revealed pretibial edema, hepatomegaly and bilateral pulmonary crepitations. 3/6 systolic murmur was present on mitral valve area. Transthoracic and transesophageal echocardiography revealed a vegetation like mobile mass with 3,1x0,7cm in dimensions that subtotally obstructed mechanical mitral valve. Haemoculture negative prosthetic valve endocarditis was diagnosed. Antibiotherapy, that was started preoperatively, was continued 4 weeks after the operation. During the operation it was found that mechanical mitral valve prosthesis was almost totally obstructed by huge vegetation and pannus formation. Mitral valve was removed and replaced with a bileaflet mechanical valve. Inotropic support was used during the intensive care unit period. Late postoperative period was uneventful. Vegetation and pannus formations in mechanical valve prosthesis can cause severe complications. Surgical treatment combined with antibiotherapy can be used with auspicious results.
Prothesis obstruction after mechanical cover replacement is a complication that is rare but can lead to serious consequences. The main causes of mechanical cover obstruction include cover thrombosis, panus formation and vegetation. This article discussed the phenomenon and treatment of the mechanical mitral cover replacement that has been accepted and obstructed by large vegetation and panus formation and the hemo-cultural negative cover endocarditis. Two years ago, a 36-year-old man with a mechanical aort and mitral coating replacement surgery appeared to the clinic with breathing difficulties and high fever complaints. The patient had ortophenic, tachypne, tachycardia and high fever. In the physical examination, pretibial obesity, hepatomegaly and bilateral lungs krepitation were detected. In the mitral area there was 3/6 systolic swelling. In the transtoral and transozofageal ecocardiography, the mechanical mitral cover subtotal-touching 3,1x0,7cm-sized vegetation-like mobile mass appearance was detected. The patient was diagnosed with hemoculture negative protez cover endocarditis. In the surgery, mechanical mitral cover proteins were found in a close obstruction with large vegation and panus formation. The mitral cover was scratched and the component was replicated with a mechanical cover. There were no problems in the long-term follow-up of the patient who received intensive care with intrusive support. The preoperative antibiotic treatment was continued for 4 weeks. Mechanical cover protection is a post-replace of vegetation and panus formation that can cause serious complications. The results of surgery combined with early aggressive antibiotic therapy are face laughing.
Field : Sağlık Bilimleri
Journal Type : Uluslararası
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