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Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature.

Publication ,  Journal Article
Villafañe, J; Baker, GH; Austin, EH; Miller, S; Peng, L; Beekman, R
Published in: Catheter Cardiovasc Interv
August 1, 2014

OBJECTIVES: The objectives of this manuscript are two-fold: (a) to describe the clinical characteristics and management of four pediatric patients with bacterial endocarditis (BE) after Melody pulmonary valve implantation (MPVI); and (b) to review the literature regarding Melody pulmonary valve endocarditis. BACKGROUND: There are several reports of BE following MPVI. The clinical course, BE management and outcome remain poorly defined. METHODS: This is a multi-center report of four pediatric patients with repaired tetralogy of Fallot (TOF) and BE after MPVI. Clinical presentation, echocardiogram findings, infecting organism, BE management, and follow-up assessment are described. We review available literature on Melody pulmonary valve endocarditis and discuss the prognosis and challenges in the management of these patients. RESULTS: Of our four BE patients, two had documented vegetations and three showed worsening pulmonary stenosis. All patients remain asymptomatic after medical treatment (4) and surgical prosthesis replacement (3) at follow-up of 17 to 40 months. Analysis of published data shows that over half of patients undergo bioprosthesis explantation and that there is a 13% overall mortality. The most common BE pathogens are the Staphylococcus and Streptococcus species. CONCLUSIONS: Our case series of four pediatric patients with repaired TOF confirms a risk for BE after MPVI. A high index of suspicion for BE should be observed after MPVI. All patients should be advised to follow lifelong BE prophylaxis after MPVI. In case of BE, surgery should be considered for valve dysfunction or no clinical improvement in spite of medical treatment.

Duke Scholars

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

August 1, 2014

Volume

84

Issue

2

Start / End Page

212 / 218

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Time Factors
  • Tetralogy of Fallot
  • Reoperation
  • Pulmonary Valve Stenosis
  • Pulmonary Valve Insufficiency
  • Pulmonary Valve
  • Prosthesis-Related Infections
  • Prosthesis Design
 

Citation

APA
Chicago
ICMJE
MLA
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Villafañe, J., Baker, G. H., Austin, E. H., Miller, S., Peng, L., & Beekman, R. (2014). Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature. Catheter Cardiovasc Interv, 84(2), 212–218. https://doi.org/10.1002/ccd.25375
Villafañe, Juan, George Hamilton Baker, Erle H. Austin, Stephen Miller, Lynn Peng, and Robert Beekman. “Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature.Catheter Cardiovasc Interv 84, no. 2 (August 1, 2014): 212–18. https://doi.org/10.1002/ccd.25375.
Villafañe J, Baker GH, Austin EH, Miller S, Peng L, Beekman R. Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature. Catheter Cardiovasc Interv. 2014 Aug 1;84(2):212–8.
Villafañe, Juan, et al. “Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature.Catheter Cardiovasc Interv, vol. 84, no. 2, Aug. 2014, pp. 212–18. Pubmed, doi:10.1002/ccd.25375.
Villafañe J, Baker GH, Austin EH, Miller S, Peng L, Beekman R. Melody pulmonary valve bacterial endocarditis: experience in four pediatric patients and a review of the literature. Catheter Cardiovasc Interv. 2014 Aug 1;84(2):212–218.
Journal cover image

Published In

Catheter Cardiovasc Interv

DOI

EISSN

1522-726X

Publication Date

August 1, 2014

Volume

84

Issue

2

Start / End Page

212 / 218

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Time Factors
  • Tetralogy of Fallot
  • Reoperation
  • Pulmonary Valve Stenosis
  • Pulmonary Valve Insufficiency
  • Pulmonary Valve
  • Prosthesis-Related Infections
  • Prosthesis Design