Cor Vasa 2018, 60(2):e174-e178 | DOI: 10.1016/j.crvasa.2017.01.006

Late infective endocarditis of an Amplatzer atrial septal device twelve years after implantation

Tomáš Toporcer^*, Adrián Kolesár, Martin Ledecký, František Sabol

Klinika srdcovej chirurgie, Východoslovenský ústav srdcových a cievnych chorôb, a.s., a Lekárska fakulta Univerzity Pavla Jozefa Šafárika v Košiciach, Slovenská republika

Infective endocarditis was initially defined as a disease of patients with pre-existing valvular abnormalities. In contemporary medicine a valvular prosthesis and implanted medical devices are the most common risk factors for infective endocarditis.
A case report is presented regarding an 18-year-old female with a medical history of a 12-year implanted Amplatzer occluder. Echocardiography showed an endocarditis focus in the right atrium communicating to the left atrium and destruction of the non-coronary leaflet of the aortic valve, with aortic valve insufficiency. Blood culture was positive for multi-resistant Staphylococcus aureus. The aortic valve, the Amplatzer device and part of the anterior leaflet of the mitral valve were excised. Pericardium was used for reconstruction of the anterior leaflet of the mitral valve, the interatrial septum and the wall of the left atrium. A mechanical prosthesis of the aortic valve was implanted. Control echocardiography was done four months after surgery. The evaluation did not show any recurrence of endocarditis.
The published literature shows, in correlation with the presented case report, the occurrence of endocarditis late in the course of Amplatzer implantation highlights the need for vigilance in the population of patients with the device.

Keywords: Amplatzer occluder; Infective endocarditis; Staphylococcus aureus

Received: July 3, 2016; Revised: January 9, 2017; Accepted: January 10, 2017; Published: April 1, 2018  Show citation