Infective endocarditis is a significant public health challenge, with high mortality and morbidity. A 79-year-old man, post-aortic bioprosthetic implantation, presented with chest pain. An electrocardiogram indicated anterior ST-elevation myocardial infarction. Urgent coronary angiography showed critical left anterior descending artery stenosis, treated with angioplasty and a drug-eluting stent. Transthoracic and transesophageal echocardiograms revealed nosocomial endocarditis on the aortic bioprosthetic and a significant peri-prosthetic abscess. Blood cultures identified multidrug-resistant Staphylococcus haemolyticus. Despite surgical recommendations, the patient opted for intra-hospital antibiotic therapy and home care after repeated transesophageal echocardiograms. Remarkably, this case underscores the rare and significant success of conservative therapy in resolving a paravalvular abscess, a condition typically necessitating surgical intervention. This extraordinary outcome highlights the potential for non-surgical management in selected cases. The patient remains in good health upon follow-up, emphasizing the importance of multidisciplinary care and vigilant monitoring.
A multifaceted prosthetic valve infective endocarditis
Gallina S.;
2025-01-01
Abstract
Infective endocarditis is a significant public health challenge, with high mortality and morbidity. A 79-year-old man, post-aortic bioprosthetic implantation, presented with chest pain. An electrocardiogram indicated anterior ST-elevation myocardial infarction. Urgent coronary angiography showed critical left anterior descending artery stenosis, treated with angioplasty and a drug-eluting stent. Transthoracic and transesophageal echocardiograms revealed nosocomial endocarditis on the aortic bioprosthetic and a significant peri-prosthetic abscess. Blood cultures identified multidrug-resistant Staphylococcus haemolyticus. Despite surgical recommendations, the patient opted for intra-hospital antibiotic therapy and home care after repeated transesophageal echocardiograms. Remarkably, this case underscores the rare and significant success of conservative therapy in resolving a paravalvular abscess, a condition typically necessitating surgical intervention. This extraordinary outcome highlights the potential for non-surgical management in selected cases. The patient remains in good health upon follow-up, emphasizing the importance of multidisciplinary care and vigilant monitoring.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
