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Case Reports

Pulmonary Valve Replacement for Pacing Electrodes Related Bacterial Endocarditis

Vilém Rohn, MD, PhD^a,_*, Marek lais, MD^a, Tomá Kotulák, MD^b, Michal Penika, MD^c

^a Clinic of Cardiovascular Surgery, Charles University Teaching Hospital, Prague, Czech Republic
^b Clinic of Anesthesiology and Resuscitation, Charles University Teaching Hospital, Prague, Czech Republic
^c Clinic of Cardiology, Charles University Teaching Hospital, Prague, Czech Republic

Accepted for publication December 3, 2007.

^_* Address correspondence to Dr Rohn, Clinic of Cardiovascular Surgery, Charles University Teaching Hospital, U Nemocnice 2, 128 00 Praha 2, Czech Republic (Email: vilem.rohn{at}vfn.cz).

Infective endocarditis of pulmonary valve requiring surgery is rare. We report a case of 80-year-old woman with a permanent pacemaker implanted 14 years ago. She had signs of infection resistant to antibiotic therapy, secondary cachexia, and dyspnea. Echocardiography examination revealed an infectious mass on pacing electrodes in the right atrium, right ventricular dysfunction, and pulmonary hypertension. Removal of the infected pacing system was indicated. During the operation, destruction of the pulmonary valve due to bacterial endocarditis was diagnosed. Replacement with a stented porcine valve was performed. The patient was discharged on postoperative day 20. Seven months after the operation, the patient is in a good condition.