PULMONARY VALVE-REPLACEMENT FOR ENDOCARDI TIS - 2 CASE-REPORTS

The authors report two cases of pulmonary valve endocarditis which req uired emergency surgical treatment. A 74 year old patient with trivalv ular endocarditis (pulmonary, aortic, mitral), due to Sptreptococcus D bovis, developed cardiogenic shock with acute pulmonary oedema and un derwent double aortic and pulmonary valve replacement with Carpentier- Edwards prostheses and simple resection of a mitral valve vegetation. Another 36 year old drug addict developed isolated pulmonary valve end ocarditis due to Staphylococcus aureus infection complicated by pulmon ary regurgitation with right ventricular failure and by septic pulmona ry embolism with persistent sepsis: he underwent pulmonary valve repla cement with a Brave 300 bioprosthesis. The postoperative course was un complicated in both cases, with interruption of the infection and norm alisation of the hemodynamic status. The insidious and severe nature o f pulmonary valve endocarditis is demonstrated by these two cases, con firming previous reports which have underlined the poor prognosis of t his condition. Surgery has been shown to be effective and well tolerat ed and should be integrated early in the therapeutic strategy, the res ults being all the better when an aggressive attitude is taken.