Pulmonary Valve Replacement Through a Left Minithoracotomy: An Alternate Approach

• Published in: The Annals of thoracic surgery Vol. 98; no. 5; pp. 1827 - 1829
• Main Authors: Cheema, Faisal H., MD, Heng, Elbert E, Rehman, Atiq, MD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.11.2014
• Subjects: Bioprosthesis; Cardiothoracic Surgery; Echocardiography, Transesophageal; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - diagnosis; Endocarditis, Bacterial - microbiology; Female; Heart Valve Diseases - diagnosis; Heart Valve Diseases - etiology; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation - methods; Humans; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Minimally Invasive Surgical Procedures - methods; Pulmonary Valve - surgery; Staphylococcal Infections - complications; Staphylococcal Infections - diagnosis; Staphylococcal Infections - microbiology; Surgery; Thoracotomy - methods; Young Adult; 35
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2013.12.085

We present a case of an isolated pulmonary valve endocarditis in a 23-year-old woman with a history of heavy oxycodone abuse. She presented with fever and positive cultures for methicillin-sensitive Staphylococcus aureus . A transesophageal echocardiogram demonstrated a 3-cm vegetation of the pulmonary valve. Antibiotic therapy was started but she continued to have fever and the vegetation size did not change. In view of ongoing fever and risk of embolization, a left minithoracotomy was performed, and the pulmonary valve was replaced with a bioprosthesis using warm cardiopulmonary bypass, with a beating-heart technique. The patient had an uneventful postoperative course and was discharged home. To the best of our knowledge, this is the first case of a pulmonary valve replacement through this approach.