A Case of Valve Repair for Active Infective Endocarditis Located in the Tricuspid Valve

(Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan)

Ikutaro Kigawa Haruo Yamauchi Sumio Miura
Sachito Fukuda Takeshi Miyairi
We report surgically treated case of tricuspid valve endocarditis in a non-drug addict. A 35-year-old man with no history of cardiac disease was admitted to our institution for persistent fever. His blood culture was positive for methicillin-sensitive Staphylococcus aureus(MSSA). Echocardiography showed friable vegetations attached to the tricuspid valve with moderate tricuspid regurgitation. No other valves were affected. Chest computed tomography revealed multiple septic pulmonary emboli in both lungs. The infection was uncontrollable, so despite 6 weeks’ of appropriate intravenous antibiotics therapy, he required surgery. Infected lesions had extended to parts of the septal leaflet and the posterior leaflet of the tricuspid valve. Valve repair with the resection-suture technique was performed. Half of the septal leaflet and a part of the posterior leaflet were excised with the vegetations, and the remaining septal leaflet was sutured to the posterior leaflet after annular plication without implanting an artificial ring. The postoperative course was uneventful, without further tricuspid regurgitation or stenosis. He was discharged after additional antibiotic administration for 4 weeks postoperatively, and he has remained free from endocarditis for over 1 year.
  Jpn. J. Cardiovasc. Surg. 39:78-81(2010)

Keywords:tricuspid valve endocarditis, active endocarditis, tricuspid valve repair, septic pulmonary emboli