Covered Stent as a Bridge to Surgery for Obstructive Melody Pulmonary Valve Endocarditis.
Domenico SiricoAura VîjîiacAleksander KempnyGuido MichielonAlain FraissePublished in: Pediatric cardiology (2019)
Endocarditis is life threatening after percutaneous pulmonary valve implantation. We report a patient with acute heart failure caused by obstructive pulmonary vegetation in a Melody valve. Because of severe right ventricular dysfunction, immediate cardiac surgery was contraindicated. The patient underwent trans-catheter implantation of a covered stent to relieve obstruction. Following an initially good outcome, surgery was performed 2 weeks later. This was complicated by left main coronary artery tear and fatal bleeding. Despite covered stent was an effective bridge, surgery remains extremely challenging in such cases with important surrounding inflammation and fibrosis as well as potential proximity of coronary arteries.
Keyphrases
- minimally invasive
- coronary artery
- coronary artery bypass
- aortic valve
- pulmonary hypertension
- mitral valve
- acute heart failure
- aortic stenosis
- cardiac surgery
- pulmonary artery
- oxidative stress
- surgical site infection
- heart failure
- coronary artery disease
- acute kidney injury
- ultrasound guided
- risk assessment
- left ventricular
- pulmonary arterial hypertension
- early onset
- acute coronary syndrome
- gestational age