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    Dehiscence and embolization of CorMatrix tricuspid valve replacement in the setting of infective endocarditis: a case report

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    Author
    Tomdio, Anna N.; Moey, Melissa Y.Y.; Siddiqui, Irfan; Movahed, Assad
    Abstract
    Background: Due to increased morbidity and mortality, prosthetic valve infective endocarditis (IE) with dehiscence requires urgent intervention. Early identification and therapy may prevent embolization. Case summary: A 27-year-old Caucasian woman with a history of hepatitis C, intravenous drug abuse, and tricuspid valve (TV) replacement was admitted for recurrent IE. She was found to have bacteraemia and fungaemia, and empiric antibiotics were initiated. Transthoracic echocardiogram (TTE) revealed a mobile ‘mass’ on the TV and dehiscence. The patient developed cardiogenic shock and repeat TTE showed a ruptured TV and absence of the ‘mass’, suspicious of embolization. She underwent emergent surgery with TV replacement using a Biocor valve and retrieval of the old CorMatrix valve found in the right mid pulmonary artery (PA). The patient was successfully weaned off inotropic agents and completed a prolonged course of antibiotics and anti-fungals. Discussion: The multi-disciplinary decision on timing of surgical intervention was challenging, especially due to ongoing mycobacterial infection that increased operative risk. With clinical deterioration, urgent surgery was performed revealing an embolized prosthetic valve in the PA. New surgical options for TV replacement in IE with extracellular-based material have shown promising outcomes with little reported data of long term complications. This case demonstrates a rare occurrence of embolized CorMatrix TV and highlights the challenge in timing of appropriate surgical intervention in a septic patient with thrombocytopenia.
    URI
    http://hdl.handle.net/10342/8439
    Subject
    Case report, Infective endocarditis, CorMatrix valve, Tricuspid valve, Bacteraemia, Cardiogenic shock, Sepsis
    Date
    2018-01-31
    Citation:
    APA:
    Tomdio, Anna N., & Moey, Melissa Y.Y., & Siddiqui, Irfan, & Movahed, Assad. (January 2018). Dehiscence and embolization of CorMatrix tricuspid valve replacement in the setting of infective endocarditis: a case report. , (), - . Retrieved from http://hdl.handle.net/10342/8439

    Display/Hide MLA, Chicago and APA citation formats.

    MLA:
    Tomdio, Anna N., and Moey, Melissa Y.Y., and Siddiqui, Irfan, and Movahed, Assad. "Dehiscence and embolization of CorMatrix tricuspid valve replacement in the setting of infective endocarditis: a case report". . . (), January 2018. May 31, 2023. http://hdl.handle.net/10342/8439.
    Chicago:
    Tomdio, Anna N. and Moey, Melissa Y.Y. and Siddiqui, Irfan and Movahed, Assad, "Dehiscence and embolization of CorMatrix tricuspid valve replacement in the setting of infective endocarditis: a case report," , no. (January 2018), http://hdl.handle.net/10342/8439 (accessed May 31, 2023).
    AMA:
    Tomdio, Anna N., Moey, Melissa Y.Y., Siddiqui, Irfan, Movahed, Assad. Dehiscence and embolization of CorMatrix tricuspid valve replacement in the setting of infective endocarditis: a case report. . January 2018; (): . http://hdl.handle.net/10342/8439. Accessed May 31, 2023.
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