A 33-year-old man with multiple prior cardiac repairs for co | Figure 1
A Case of Endocarditis
A 33-year-old man with multiple prior cardiac repairs for congenital heart disease was diagnosed with endocarditis of his Melody valve of unclear source and extent.
Surgery revealed extensive infection and showed the infected Melody valve to be contained within multiple layers of RVOT stents. While the infected tissues were being debrided and the RVOT conduit was being removed, a gush of blood rushed from the left ventricle, indicating involvement of a previously placed ventricular septal defect patch. Quick measures were taken to stop the heart, remove the patch and the aortic valve, and then swiftly replace the valve, the ventricular patch and the conduit.
This is just one of the countless “nightmare scenarios” that can suddenly arise in congenital heart surgery. It’s also one of a pair of scenarios that help illustrate 5 practical principles our surgeons advocate for navigating the inevitable quagmires encountered in congenital heart surgery.
Related Cases
Similar Cases
4 month old infant. Post op day one. Can anyone guess the surgery performed? Infant was born with a congenital heart defect. Also, what setting is the infant being paced at?
A 23-year-old woman with a history of surgery for repair of aortic coarctation in childhood is referred for echocardiography. Which of the following is most likely to be found in this patient?
A. Cleft mitral valve
B. Bicuspid aortic valve
C. Ventricular septal defect
D. Ebstein anomaly
E. Pulmonic stenosis