HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Igor E. Konstantinov Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Konstantinov, I. E. Search for Related Content PubMed Articles by Konstantinov, I. E. Related Collections Cardiac - other Pericardium Valve disease

J Thorac Cardiovasc Surg 2008;136:531-532
© 2008 The American Association for Thoracic Surgery

Brief Communication

Total resection and complete reconstruction of the tricuspid valve in acute infective endocarditis

Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Australia

Received for publication December 20, 2007; accepted for publication December 24, 2007.

^_* Address for reprints: Igor E. Konstantinov, MD, PhD, Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, G Block, Hospital Avenue, Perth, WA 6009 Australia. (Email: konstantinov.igor@alumni.mayo.edu).

The first 20% of the full text of this article appears below.

Acute infective endocarditis of the tricuspid valve (TV) in noncompliant intravenous drug abusers presents a difficult problem. Progressive sepsis despite appropriate antibiotics necessitates surgical intervention. These noncompliant patients, however, often leave the hospital against medical advice. The risk of prosthetic endocarditis in this group of patients is very high. Complete resection of the valve without replacement, although feasible, can result in progressive right-sided heart failure. Reconstruction of the TV might be an alternative option.

Clinical Summary

A 33-year-old man with a long history of intravenous drug abuse was admitted with fever and chills. He previously underwent drainage of an infected left hip joint, as well as multiple bilateral groin abscesses at the site of drug injection. Multiple blood cultures demonstrated Staphylococcus aureus. Despite appropriate antibiotic coverage, uncontrolled sepsis developed. Echocardiographic analysis demonstrated large multiple vegetations of the TV ( Figure 1, A) and an . . . [Full Text of this Article]