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Miami Minimally Invasive Valves
Joseph Lamelas, MD
Dedicated to the Advancement of Minimally Invasive Cardiac Surgery
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Posts tagged as endocarditis

Prosthetic AV endocarditis is a difficult pathology to deal with.  In the past my first strategy would be to automatically use an AV homograft.  There are specific cases in which a patch can be placed in the healed abcess cavity and a bioprosthetic valve can be implanted.

I have enclosed pictures demonstrating a case in which I performed a minimally invasive AVR 4 years ago and the patient returned with AV endocarditis with a large annular abcess that encircled the left and non coronary infra-annular regions.  He was previously treated with IV antibiotics several times and now returned with severe paravalvular AI.  I performed a redo minimally invasive (right anterior thoracotomy),  removed the old valve,  debrided the annulus,  placed a large pericardial patch to cover a very large defect and then implanted a new valve. The valve sutures are placed through the patch and into the newly created annulus, which will be the superior aspect of the patch which incorporates aorta.

This is a very good solution to a potentially lethal problem.DSCN9260DSCN9265DSCN9273

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