Redo an Aortic Valve Replacement for Bioprosthetic Valve Destruction in a Patient Developing Streptococcus Bacteremia Three Years After the Initial Operation

Satoru Maeba, MD,1 Takahiro Taguchi, MD,1 Keitaro Watanabe, MD,1 and Taijiro Sueda, MD, PhD2

A 66-year-old man with a bioprosthetic aortic valve developed Streptococcus bacteremia and was treated with antibiotics. He responded well to this therapy, and no evidence of bioprosthetic valve endocarditis (BVE) was detected at this time. One-and-a-half years after the antibiotic therapy for bacteremia, the patient was referred to our department with a diagnosis of acute cardiac failure. Transthoracic echocardiography revealed torn bioprosthetic valve leaflets with severe aortic regurgitation. A redo aortic valve replacement was undertaken, followed by antibiotic therapy for 6 weeks after the surgery. A histopathological examination of the surgically resected valve suggested a healed infective BVE. No recurrence of bacteremia has been noted since the reoperation. (Ann Thorac Cardiovasc Surg 2010; 16: 210-212)

Key words: bioprosthetic valve endocarditis, bioprosthetic valve destruction, bacteremia, aortic valve replacement

1Department of Cardiovascular Surgery, Takeda General Hospital Foundation, Fukushima, Japan; and 2Department of Cardiovascular Surgery Hiroshima University Hospital, Hiroshima, Japan

Received October 14, 2009; accepted for publication March 5, 2010
Address reprint requests to Satoru Maeba, MD: 3–27 Yamagamachi, Aizuwakamatsu, Fukushima 965–8585, Japan.