Skip to main content

Advertisement

SpringerLink
Log in

Urgent aortic valve replacement for infective endocarditis during the 23rd week of pregnancy

  • Case Report
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Infective endocarditis is a rare but serious complication of pregnancy with high maternal and fetal mortality. Surgical intervention is an option when medical therapy fails. We report the case of a 23-year-old female with severe aortic valve regurgitation and hemodynamic compromise related to acute bacterial endocarditis of a congenital bicuspid aortic valve during the 23rd week of pregnancy. She underwent urgent aortic valve replacement and, despite implementation of known fetal-protection strategies, fetal demise occurred.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Muretti M, Torre TM, Mauri R, Trunfio R, Moschovitis G, Siclari F. Mitral valve replacement in pregnancy: a successful strategy for fetal survival. J Heart Valve Dis. 2010;19:789–91.

    PubMed  Google Scholar 

  2. Wijesinghe N, Sebastian C, McAlister HF, Devlin GP. Outcome of pregnancy complicated by infective endocarditis: a review of published literature over the last three decades. Heart Lung Circ. 2007;16:S-77.

    Google Scholar 

  3. Parry A, Westaby S. Cardiac surgery during pregnancy. In: Franco KL, Verrier ED, editors. Advanced therapy in cardiac surgery. Hamilton: BC Decker; 1999. p. 25–37.

    Google Scholar 

  4. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, et al. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation. 2005;111:e394–434.

    Article  PubMed  Google Scholar 

  5. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009;30:2369–413.

    Article  PubMed  Google Scholar 

  6. Bataskov K, Hariharan S, Horowitz MD, Neibart RM, Cox MM. Gonococcal endocarditis complicating pregnancy: a case report and literature review. Obstet Gynecol. 1991;78:494–6.

    PubMed  CAS  Google Scholar 

  7. Sexton DJ, Spelman D. Current best practices and guidelines: assessment and management of complications in infective endocarditis. Cardiol Clin. 2003;21:273–82.

    Article  PubMed  Google Scholar 

  8. Hockmuth DR, Mills NI. Management of unusual problems. In: Gravlee GP, Davis RF, Utley JR, editors. Cardiopulmonary bypass: principles and practice. Baltimore: Williams and Wilkins; 1993. p. 746–50.

    Google Scholar 

  9. Mihaljevic T, Paul S, Leacche M, Rawn JD, Cohn LH, Byrne JG. Valve replacement in women of childbearing age: influences on mother, fetus and neonate. J Heart Valve Dis. 2005;14:151–7.

    PubMed  Google Scholar 

  10. Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. J Arch Intern Med. 2000;160:191–6.

    Article  CAS  Google Scholar 

  11. Korsten HH, Van Zundert AA, Mooij PN, De Jong PA, Bavinck JH. Emergency aortic valve replacement in the 24th week of pregnancy. Acta Anaesthesiol Belg. 1989;40:201–5.

    PubMed  CAS  Google Scholar 

  12. Mahli A, Izdes S, Coskun D. Cardiac operations during pregnancy: review of factors influencing fetal outcome. Ann Thorac Surg. 2000;69:1622–6.

    Article  PubMed  CAS  Google Scholar 

  13. Vedrinne C, Tronc F, Martinot S, Robin J, Allevard AM, Vincent M, et al. Better preservation of endothelial function and decreased activation of the fetal renin-angiotensin pathway with the use of pulsatile flow during experimental fetal bypass. J Thorac Cardiovasc Surg. 2000;120:770–7.

    Article  PubMed  CAS  Google Scholar 

  14. Pomini F, Mercogliano D, Cavalletti C, Caruso A, Pomini P. Cardiopulmonary bypass in pregnancy. Ann Thorac Surg. 2003;76:1605–8.

    Article  Google Scholar 

  15. Marcoux J, Rosin M, Mycyk T. CPB-assisted aortic valve replacement in a pregnant 27-year-old with endocarditis. Perfusion. 2009;24:361–4.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors report no conflict of interest. There has been no financial assistance with the project.

Author information

Author notes

  1. Christodoulos Kaoutzanis

    Present address: Saint Joseph Mercy Health System, Department of Surgery, 5333 McAuley Drive, Reichert Health Building, Suite R-2111, Ann Arbor, MI, 48106, US

Authors and Affiliations

  1. Department of Cardiovascular and Thoracic Surgery, Nicosia General Hospital, Nicosia, Cyprus

    Christodoulos Kaoutzanis, Erotokritos Evangelakis, Chrysostomos Kokkinos & Gavriel Kaoutzanis

Authors
  1. Christodoulos Kaoutzanis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Erotokritos Evangelakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chrysostomos Kokkinos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gavriel Kaoutzanis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christodoulos Kaoutzanis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kaoutzanis, C., Evangelakis, E., Kokkinos, C. et al. Urgent aortic valve replacement for infective endocarditis during the 23rd week of pregnancy. Gen Thorac Cardiovasc Surg 61, 296–300 (2013). https://doi.org/10.1007/s11748-012-0140-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-012-0140-1

Keywords

Search

Navigation