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Published in: Journal of Cardiothoracic Surgery 1/2021

Open Access 01-12-2021 | Pulmonary Valve Replacement | Case report

Isolated pulmonary valve endocarditis with rapid progression: a case report and literature review

Authors: Ming-Xuan Zhang, Wei-Min Zhang, Chan Yu, Bo-Wen Zhao, Ran Chen, Mei Pan, Bei Wang

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

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Abstract

Background

Isolated pulmonary valve endocarditis (IPE) is rare, accounting for 1.5–2% of all cases of infective endocarditis. Herein, we describe a case of isolated pulmonary valve endocarditis with rapid progression in a 28-year-old male. Unlike most patients reported previously who were cured with only anti-infective therapy, without surgery at an early stage, multiple complications occurred in this patient in less than 2 weeks.

Case presentation

The patient was diagnosed with pulmonary valve endocarditis with blood cultures showing Staphylococcus aureus and echocardiography revealing 2 masses (measuring 14*13 mm、11*16 mm in size). Only 12 days later, acute massive pulmonary embolism occurred. Then, repeated echocardiography revealed multiple masses attached to the pulmonary valve with severe pulmonary insufficiency and the possibility of pulmonary valve destruction. Finally, pulmonary valve replacement, vegetation removal, and right pulmonary thromboendarterectomy together with resection of the middle and lower lobes of the right lung were performed.

Conclusions

The role of surgery at an early stage might need to be reconsidered, and it may be viable to combine medical and surgical approaches.
Literature
1.
go back to reference Reza AS, Anand D, Cheng SH, Anand D. Rare cause for a common presentation: isolated pulmonary valve endocarditis yet another mimicker. BMJ Case Rep. 2018;2018:bcr-2018-224703. Reza AS, Anand D, Cheng SH, Anand D. Rare cause for a common presentation: isolated pulmonary valve endocarditis yet another mimicker. BMJ Case Rep. 2018;2018:bcr-2018-224703.
2.
go back to reference Glew T, Feliciano M, Finkielstein D, Hecht S, Hoffman D. Pulmonic valve repair in a patient with isolated pulmonic valve endocarditis and sickle cell disease. Case Rep Cardiol. 2015;2015:732073.PubMedPubMedCentral Glew T, Feliciano M, Finkielstein D, Hecht S, Hoffman D. Pulmonic valve repair in a patient with isolated pulmonic valve endocarditis and sickle cell disease. Case Rep Cardiol. 2015;2015:732073.PubMedPubMedCentral
3.
go back to reference Murdoch DR, Corey GR, Hoen B, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the international collaboration on endocarditis-prospective cohort study. Arch Intern Med. 2009;169(5):463–73.CrossRef Murdoch DR, Corey GR, Hoen B, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the international collaboration on endocarditis-prospective cohort study. Arch Intern Med. 2009;169(5):463–73.CrossRef
4.
go back to reference Witten JC, Hussain ST, Shrestha NK, et al. Surgical treatment of right-sided infective endocarditis. J Thorac Cardiovasc Surg. 2019;157(4):1418–1427.e14. Witten JC, Hussain ST, Shrestha NK, et al. Surgical treatment of right-sided infective endocarditis. J Thorac Cardiovasc Surg. 2019;157(4):1418–1427.e14.
5.
go back to reference Vilacosta I, Graupner C, San Román JA, et al. Risk of embolization after institution of antibiotic therapy for infective endocarditis. J Am Coll Cardiol. 2002;39(9):1489–95.CrossRef Vilacosta I, Graupner C, San Román JA, et al. Risk of embolization after institution of antibiotic therapy for infective endocarditis. J Am Coll Cardiol. 2002;39(9):1489–95.CrossRef
6.
go back to reference Ilhão Moreira R, Coutinho Cruz M, Moura Branco L, et al. Infective endocarditis: Surgical management and prognostic predictors. Rev Port Cardiol. 2018;37(5):387–94 English, Portuguese.CrossRef Ilhão Moreira R, Coutinho Cruz M, Moura Branco L, et al. Infective endocarditis: Surgical management and prognostic predictors. Rev Port Cardiol. 2018;37(5):387–94 English, Portuguese.CrossRef
7.
go back to reference San Román JA, López J, Vilacosta I, et al. Prognostic stratification of patients with left-sided endocarditis determined at admission. Am J Med. 2007;120(4):369 e1–7.CrossRef San Román JA, López J, Vilacosta I, et al. Prognostic stratification of patients with left-sided endocarditis determined at admission. Am J Med. 2007;120(4):369 e1–7.CrossRef
8.
go back to reference Misfeld M, Girrbach F, Etz CD, et al. Surgery for infective endocarditis complicated by cerebral embolism: a consecutive series of 375 patients. J Thorac Cardiovasc Surg. 2014;147(6):1837–44.CrossRef Misfeld M, Girrbach F, Etz CD, et al. Surgery for infective endocarditis complicated by cerebral embolism: a consecutive series of 375 patients. J Thorac Cardiovasc Surg. 2014;147(6):1837–44.CrossRef
9.
go back to reference Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and Management of Complications: a scientific statement for healthcare professionals from the American Heart Association [published correction appears in circulation. 2015 Oct 27;132(17):e215] [published correction appears in circulation. 2016 Aug 23;134(8):e113] [published correction appears in circulation. 2018 Jul 31;138(5):e78-e79]. Circulation. 2015;132(15):1435–86.CrossRef Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and Management of Complications: a scientific statement for healthcare professionals from the American Heart Association [published correction appears in circulation. 2015 Oct 27;132(17):e215] [published correction appears in circulation. 2016 Aug 23;134(8):e113] [published correction appears in circulation. 2018 Jul 31;138(5):e78-e79]. Circulation. 2015;132(15):1435–86.CrossRef
10.
go back to reference Schroeder RA. Pulmonic valve endocarditis in a normal heart. J Am Soc Echocardiogr. 2005;18(2):197–8.CrossRef Schroeder RA. Pulmonic valve endocarditis in a normal heart. J Am Soc Echocardiogr. 2005;18(2):197–8.CrossRef
11.
go back to reference Robbins MJ, Soeiro R, Frishman WH, Strom JA. Right-sided valvular endocarditis: etiology, diagnosis, and an approach to therapy. Am Heart J. 1986;111(1):128–35.CrossRef Robbins MJ, Soeiro R, Frishman WH, Strom JA. Right-sided valvular endocarditis: etiology, diagnosis, and an approach to therapy. Am Heart J. 1986;111(1):128–35.CrossRef
12.
go back to reference Desch S, Freund A, de Waha S, et al. Outcome in patients with left-sided native-valve infective endocarditis and isolated large vegetations. Clin Cardiol. 2014;37(10):626–33.CrossRef Desch S, Freund A, de Waha S, et al. Outcome in patients with left-sided native-valve infective endocarditis and isolated large vegetations. Clin Cardiol. 2014;37(10):626–33.CrossRef
13.
go back to reference Chirouze C, Alla F, Fowler VG Jr, et al. Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the international collaboration of endocarditis-prospective cohort study. Clin Infect Dis. 2015;60(5):741–9.CrossRef Chirouze C, Alla F, Fowler VG Jr, et al. Impact of early valve surgery on outcome of Staphylococcus aureus prosthetic valve infective endocarditis: analysis in the international collaboration of endocarditis-prospective cohort study. Clin Infect Dis. 2015;60(5):741–9.CrossRef
14.
go back to reference Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36(44):3075–128.CrossRef Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC guidelines for the management of infective endocarditis: the task force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36(44):3075–128.CrossRef
15.
go back to reference Hussain ST, Shrestha NK, Witten J, et al. Rarity of invasiveness in right-sided infective endocarditis. J Thorac Cardiovasc Surg. 2018;155(1):54–61 e1.CrossRef Hussain ST, Shrestha NK, Witten J, et al. Rarity of invasiveness in right-sided infective endocarditis. J Thorac Cardiovasc Surg. 2018;155(1):54–61 e1.CrossRef
16.
go back to reference Liekiene D, Bezuska L, Semeniene P, Cypiene R, Lebetkevicius V, Tarutis V, Barysiene J, Rucinskas K, Sirvydis V. Surgical treatment of infective endocarditis in pulmonary Position-15 years single Centre experience. Medicina (Kaunas). 2019;55(9):608.CrossRef Liekiene D, Bezuska L, Semeniene P, Cypiene R, Lebetkevicius V, Tarutis V, Barysiene J, Rucinskas K, Sirvydis V. Surgical treatment of infective endocarditis in pulmonary Position-15 years single Centre experience. Medicina (Kaunas). 2019;55(9):608.CrossRef
17.
go back to reference Miranda WR, Connolly HM, DeSimone DC, et al. Infective Endocarditis Involving the Pulmonary Valve. Am J Cardiol. 2015;116(12):1928–31.CrossRef Miranda WR, Connolly HM, DeSimone DC, et al. Infective Endocarditis Involving the Pulmonary Valve. Am J Cardiol. 2015;116(12):1928–31.CrossRef
18.
go back to reference Zhai H, Miao Q. Surgical valve repair of isolated pulmonary valve endocarditis. Interact Cardiovasc Thorac Surg. 2013;16(3):384–6.CrossRef Zhai H, Miao Q. Surgical valve repair of isolated pulmonary valve endocarditis. Interact Cardiovasc Thorac Surg. 2013;16(3):384–6.CrossRef
Metadata
Title
Isolated pulmonary valve endocarditis with rapid progression: a case report and literature review
Authors
Ming-Xuan Zhang
Wei-Min Zhang
Chan Yu
Bo-Wen Zhao
Ran Chen
Mei Pan
Bei Wang
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-020-01375-w

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