Some tricuspid valve endocarditis can be controlled effectively. With specific antibiotic treatment. However, surgical intervention is necessary when there are continuing sepsis, moderate or severe heart failure, multiple pulmonary emboli, and
echocardiographycally demonstrated vegitations.
We are repoting a 19 year-old male patient who was admitted for the treatment of infective endocarditis. He previously had an operation for ventriculer septal defect(perimembranous type) about 9 years ago.
An echocardiogram showed a large vegetation on the anterior cusp area and a left to right shunt through VSD, which was previously closed with dacron patch. A valve replacement in addition to antibiotic therapy was recommended for the patient.
The patient underwent on operation; tricuspid valve replacement was done with St. Jude medical valve prosthesis(33mm), and in addition to above procedure, removal of vegetation and direct closure of VSD were done.
Postoperative echocadiogram showed that replaced tricuspid valve functioned well and vegetation and shunt flow were not observed. The patient recovered without complication and discharged at Postoperative day 25.
Early aggressive surgical intervention is indicated to optimize surgical results, and this case seems to be a typical right sided bacterial endocarditis, which is caused by residual VSD We are reporting a case of tricuspid valve endocarditis with
a
review of the literature.
|