Fatal systemic embolism caused by prosthetic valve endocarditis after
Bentall surgery
Abstract
Background: Prosthetic valve endocarditis (PVE) is a rare but
dangerous complication after Bentall surgery. In addition, cases of
Staphylococcus epidermidis involving multiple valves
simultaneously and multi-organ embolism during the early postoperative
period are rarer. Case presentation: We reported a 42-year-old
patient who developed PVE with systemic embolism one month after aortic
valve replacement (Bentall surgery). Echocardiography suggested large,
mobile vegetations on both the prosthetic aortic valve and native
tricuspid valve. The patient immediately received antibiotic treatment
after the presence of Staphylococcus epidermidis was revealed by
multiple blood cultures. Shortly after that, the patient felt numbness
in the right lower extremity and received a vascular ultrasonography
examination. The Pathological exam revealed right femoral artery
thromboembolism. The patient also developed cerebral and splenic
infarction during follow-ups and died of cerebral infarction.
Conclusions: We reported a sporadic case of
Staphylococcus epidermidis infective endocarditis (IE)
involving multiple valves and systemic embolisms early after Bentall
surgery in a patient with Marfan’s syndrome. Fatal systemic embolism
should be aware of in PVE patients with large vegetations present with
dyskinesia, abdominal pain, and limb numbness. The prompt
echocardiography and vascular ultrasound are primary and reliable
diagnostic methods in this scenario.