A Single Center Experience of Prosthesis Endocarditis in the Pulmonary Position

Objective: Surgical reintervention for prosthesis endocarditis after implantation of right ventricular outflow tract (RVOT) conduits is a concern for patients and treating physicians. The scope of this study was to report our single center experience in a large patient population.

Methods: From 1999 to 2013, 306 patients underwent a surgical replacement of RVOT Conduit.

Results: Surgical intervention for endocarditis was performed in eight patients (five male, three female) (2.6%), 6.2 ± 3.9 years after the last operation. Four patients had a tetralogy of Fallot, three patients had a common arterial trunk and one patient had an aortic valve stenosis as underlying disease.

Positive blood culture was observed with Streptococcus species in three patients and with Staphylococcus species in 2 patients and with Granulicatella adiacens in one patient. In one patient the blood culture was negative. Of eight patients, two patients had an embolic event. There were four Contegra, one Matrix, one Hancock, one Shelhigh, and one Melody explanted two patients received Homograft and three patients Contegra, two patients had a Labcor, and a Hancock was implanted by one patient. There was no early or late mortality. The hospital stay was 32 ± 19 days. There was no recurrent prosthesis endocarditis. The mean follow up was 2.1 ± 2.2 years.

Conclusion: Surgical reintervention in case of prosthesis endocarditis can be performed with low morbidity and mortality. The use of different conduits seems to be irrelevant for the incidence of endocarditis. The number of patients may grow in the future according to the improvement in the surgical therapy of patients with pulmonary stenosis and the growing number of patients who requires repeated operation for the RVOT.