Aortic valve replacement with sutureless Perceval S valve: A case report of aortic root homograft failure in the setting of Streptococcus constellatus endocarditis

J Card Surg. 2020 Oct;35(10):2829-2831. doi: 10.1111/jocs.14846. Epub 2020 Jul 17.

Abstract

Background: Surgery for failed homograft aortic root replacement with extensive calcification in the setting of endocarditis alone is very challenging.

Case summary: We report the case of redo aortic valve replacement and mitral valve replacement, in a 39 years old presenting with a rare Streptococcus constellatus endocarditis of a previously implanted homograft root and native mitral valve, where conventional valve replacement proved nonfeasible. S. constellatus had caused severe tissue destruction and the extensive calcification in the homograft prevented conventional valve replacement with sutures. In this case, a sutureless valve provided a useful alternative surgical strategy.

Discussion: We consider heavily calcified failed homografts to be a good indication for sutureless (rapid deployment) valves.

Keywords: Streptococcus constellatus endocarditis; aortic valve replacement; case report; homograft aortic root replacement; sutureless valve.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Allografts
  • Aortic Valve / surgery*
  • Bioprosthesis / adverse effects*
  • Endocarditis, Bacterial / complications*
  • Endocarditis, Bacterial / microbiology
  • Heart Valve Prosthesis Implantation / methods*
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Male
  • Prosthesis Design*
  • Prosthesis Failure / adverse effects*
  • Prosthesis-Related Infections / etiology*
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / surgery*
  • Streptococcal Infections / etiology
  • Streptococcal Infections / microbiology
  • Streptococcal Infections / surgery*
  • Streptococcus constellatus*
  • Sutureless Surgical Procedures / methods*
  • Treatment Outcome