Thorac Cardiovasc Surg 2013; 61(06): 541-542
DOI: 10.1055/s-0031-1293601
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Role of Primary Bacterial Contamination of a Pulmonary Homograft for Ross Operation: Report of a Case and Review of the Literature

Alexander Blehm
1   Department of Cardiovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Nordrhein-Westfalen, Germany
,
Paulus Schurr
1   Department of Cardiovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Nordrhein-Westfalen, Germany
,
Artur Lichtenberg
1   Department of Cardiovascular Surgery, University Hospital Duesseldorf, Duesseldorf, Nordrhein-Westfalen, Germany
› Author Affiliations
Further Information

Publication History

23 April 2011

30 May 2011

Publication Date:
03 January 2012 (online)

Abstract

In a 43-year-old female, Ross operation was performed with annular reinforcement of the autograft and a cryo-fixed homograft that proved to be contaminated with enterobacter cloacae and klebsiella pneumoniae at the time of operation. Clinical course was unremarkable, perhaps due to effective antibiotic prophylaxis and treatment. In the literature, little is known about intraoperative bacterial contamination and early endocarditis. The authors report what they believe is the second reported case. Particular resistibilities of homograft and autograft might make early endocarditis unlikely.

 
  • References

  • 1 Nagy Z, Watterson KG. Ross procedure versus mechanical aortic valve replacement in young adults. Magy Seb 2008; 61 (Suppl): 23-27
  • 2 Bonow RO, Carabello BA, Kanu C , et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Society of Cardiovascular Anesthesiologists; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006; 114 (5) e84-e231
  • 3 Weymann A, Dohmen PM, Grubitzsch H, Dushe S, Holinski S, Konertz W. Clinical experience with expanded use of the Ross procedure: a paradigm shift?. J Heart Valve Dis 2010; 19 (3) 279-285
  • 4 Sievers HH, Stierle U, Charitos EI , et al; German-Dutch Ross Registry. Major adverse cardiac and cerebrovascular events after the Ross procedure: a report from the German-Dutch Ross Registry. Circulation 2010; 122 (11) S216-S223
  • 5 Melina G, El-Hamamsy I, Sinatra R, Yacoub MH. Late fulminant pulmonary valve endocarditis after the Ross operation. J Thorac Cardiovasc Surg 2010; 139 (5) e99-e100
  • 6 Elkins RC, Thompson DM, Lane MM, Elkins CC, Peyton MD. Ross operation: 16-year experience. J Thorac Cardiovasc Surg 2008; 136 (3) 623-630
  • 7 Gamez A, Castillo JC, Bonilla JL, Anguita MP. Infective endocarditis after the Ross procedure. Int J Cardiol 2011; 147 (3) e53-e54
  • 8 Wilson W, Taubert KA, Gewitz M , et al; American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee; American Heart Association Council on Cardiovascular Disease in the Young; American Heart Association Council on Clinical Cardiology; American Heart Association Council on Cardiovascular Surgery and Anesthesia; Quality of Care and Outcomes Research Interdisciplinary Working Group. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007; 116 (15) 1736-1754
  • 9 Böhm JO, Hemmer W, Rein JG , et al. A single-institution experience with the Ross operation over 11 years. Ann Thorac Surg 2009; 87 (2) 514-520
  • 10 Favaloro RR, Roura P, Gomez C, Salvatori C. Aortic valve replacement: ten-year follow up of the Ross procedure. J Heart Valve Dis 2008; 17 (5) 501-507
  • 11 Ansari A, Rigolin VH. Infective endocarditis: an update on the role of echocardiography. Curr Cardiol Rep 2010; 12 (3) 265-271