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Eur J Cardiothorac Surg 2007;32:131-132. doi:10.1016/j.ejcts.2007.03.040
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Editorial comment

Allograft aortic root replacement in complex prosthetic valve endocarditis

Department of Cardiovascular Surgery, Hospital Clinic – IDIBAPS, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain

José M. Miró

Department of Infectious Diseases, Hospital Clinic – IDIBAPS, University of Barcelona, Barcelona, Spain

^_* Corresponding author. Tel.: +34 93 2275749; fax: +34 93 4514898. (Email: cmestres@clinic.ub.es).

The first 20% of the full text of this article appears below.

Infective endocarditis (IE) is a rare disease but having significant impact on morbidity and mortality [1–3]. When it comes to prosthetic heart valves, a well-known complication after replacement therapy of heart valve disease, the problem becomes even more serious as antibiotic treatment does not fix the problem, requiring a compulsory association with early and radical surgery. In the case of the aortic position, prosthetic valve endocarditis (PVE) usually represents a complex problem due to the commonly associated extension of the disease beyond the aortic annulus to the surrounding structures with invasion of the fibrous body of the heart and eventually leading to abscess formation, and, in the most advanced disease, to aortocavitary fistulae [4,5].

Aggressive forms of PVE, as stated, do still represent a surgical challenge due to the extensive destruction of perivalvular structures. Then, in addition to the regular problems seen in IE, namely sepsis, congestive heart failure or embolic phenomena, PVE of the aortic root often renders the surgeon facing an additional problem, which is the destruction of the regular anatomy. . . . [Full Text of this Article]