There is Nothing More Invisible than the Obvious: A Case Summary and Literature Review

Author:

Alfieri Michele12,Ianni Umberto3,Molisana Michela3,Parato Vito Maurizio23

Affiliation:

1. Cardiology and Arrhythmology Clinic, Department of Cardiovascular Sciences, University Hospital “Ospedali Riuniti”, Ancona, Italy

2. Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy

3. Department of Biomedical Sciences and Public Health, Cardiology and Cardiac Rehabilitation Unit, Madonna del Soccorso Hospital, San Benedetto del Tronto, Italy

Abstract

Abstract Bioprosthetic valvular failure (BVF) is a pathological entity arising from a variety of conditions affecting prosthetic heart valves. It may present with an extremely varied pattern, and the identification of the exact etiology is vital to provide a prompt and adequate treatment. It is established that infective endocarditis mainly affects patients with intracardiac devices such as pacemakers or prosthetic valves, and it represents one of the principal mechanisms of BVF. Despite its high incidence, clinical presentations may be atypical, and a close monitoring is essential to prevent catastrophic consequences. We present the case of a partial valvular bioprosthesis detachment associated with a newly formed pseudoaneurysm due to a late infective endocarditis occurred after cardiac surgery, initially manifested with negative blood cultures and clinical findings. We also try to set up a literature review of the most common causes of valvular failure and pseudoaneurysm formation.

Publisher

Medknow

Reference21 articles.

1. 2021 ESC/EACTS Guidelines for the management of valvular heart disease:Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS);Vahanian;Rev Esp Cardiol (Engl Ed),2022

2. Standardized definition of structural valve degeneration for surgical and transcatheter bioprosthetic aortic valves;Dvir;Circulation,2018

3. Aortic bioprosthetic valve durability:Incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration;Rodriguez-Gabella;J Am Coll Cardiol,2017

4. Early failure of aortic bioprostheses:What are the mechanisms?;Mazine;Curr Opin Cardiol,2019

5. Modes of bioprosthetic valve failure:A narrative review;Koziarz;Curr Opin Cardiol,2020

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