In-vitro and In-vivo Activity of Antimicrobial-coated Prosthetic Heart Valve Sewing Cuffs
Rabih O. Darouiche MD, Mohammad D. Mansouri BS, Ricardo Meade MD

Bacterial colonization of the prosthetic heart valve sewing cuff can be a prelude to the clinical occurrence of prosthetic valve endocarditis (PVE). The potential to prevent bacterial colonization of the sewing cuff, and perhaps also PVE, has prompted an expanding interest in the efficacy of antimicrobial-coated sewing cuffs. The clinical protection afforded by central venous catheters coated with minocycline and rifampin has encouraged this coating approach to be used in prosthetic heart valve sewing cuffs. When coated with minocycline and rifampin, sewing cuffs were shown to possess broad-spectrum antimicrobial activity in vitro against Staphylococcus epidermidis, S. aureus, Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans. Minocycline/rifampin-coated devices also reduced the incidence of device colonization and infection by P. aeruginosa in an animal model These data encouraged the clinical evaluation of prosthetic heart valve sewing cuffs coated with minocycline and rifampin.