Surgical Treatment of Prosthetic Valve Endocarditis with Left Ventricular-Aortic Discontinuity: Reconstruction of Left Ventricular Outflow Tract with a Xenopericardial Conduit
Shigeaki Aoyagi MD, Shuji Fukunaga MD, Eiki Tayama MD, Nobuhiko Hayashida MD, Takemi Kawara MD

Three patients with prosthetic valve endocarditis of the aortic valve and circumferential aortic annular destruction underwent surgical treatment. In addition to aggressive debridement of the infected tissue, repair was achieved by reconstruction of the left ventricular outflow tract with a bovine pericardial conduit and fixation of the new prosthetic valve to the conduit. Two operative survivors have been followed up for 9 and 51 months, with no late deaths. No patient has experienced recurrent infection, pericardial patch aneurysm, or prosthetic valve detachment. These operative procedures provide easy and secure fixation of the pericardial patch to the healthy tissue under excellent operative view, as well as a sturdy structure for the fixation of the new prosthesis, and complete exclusion of the abscess cavity from the blood stream.