Feasibility of Low-Seated Composite Aortic Conduit for Surgical Treatment of Prosthetic Valve Endocarditis: A Case Report

Background: A 49-year-old male presented with a delayed diagnosis of infective endocarditis leading to extensive intracardiac destruction. Such cases present technical challenges operative debridement as crucial anchoring points for replacement conduits are compromised. Case Presentation: Our patient at age 49 nausea, lethargy, and diarrhea 2 weeks after recent travel. His prior history included bioprosthetic valve bicuspid aortic valve. The was first given trial antimicrobials suspected UTI. Subsequently, he admitted briefly an outside hospital “cardiac work-up,” which returned negative. sought care the third time, during developed unstable supraventricular tachycardia, prompting echocardiography 16 days following onset symptoms. Echocardiography demonstrated 6 cm abscess cavity invading interventricular septum fistula into left ventricular outflow tract, multiple septal defects (VSD), fistulae right tract. treated explant debridement. valved-conduit aorta could not be sewn annulus in usual fashion due destruction annulus, so neo-annulus created using anterior leaflet mitral tract heart below level VSDs. mechanical-valved conduit implanted onto neo-annulus. pacemaker subsequently implanted. Conclusion: In patients compromise endocarditis, low-seated, directly aorto-mitral curtain should considered novel, durable reconstructive option that allows complete infected tissues.