Severe infective endocarditis in a patient with hypertrophic obstructive cardiomyopathy: 12 years after combined surgery. A case report
https://doi.org/10.15829/1560-4071-2024-6076
EDN: LVUBIY
Abstract
Brief description. A 40-year-old male patient with obstructive hypertrophic cardiomyopathy (HCM) developed episodes of fever up to 39,0° C after carotid endarterectomy. Mitral and aortic valve Enterococcus faecium-induced infective endocarditis was diagnosed. Antibacterial therapy was continued for 3 months. As a result, the infectious and inflammatory process was suppressed, but severe mitral and aortic valve insufficiency required surgical treatment.
During the operation, the patient underwent replacement of both affected valves, as well as extended myectomy and cardioverter-defibrillator implantation to prevent sudden cardiac death. Twelve years after surgical treatment of infective endocarditis and HCM, the patient's condition is stable.
Discussion. Patients with HCM have an increased risk of infective endocarditis, but with timely diagnosis and active treatment of endocarditis, a good long-term prognosis is possible. In this case, the combined surgery played an extremely important role.
Keywords
About the Authors
Yu. A. LutokhinaRussian Federation
MD, PhD, associate professor
Moscow
V. A. Osadchaya
Russian Federation
Moscow
N. V. Morozova
Russian Federation
Moscow
N. V. Chichkova
Russian Federation
Moscow
N. A. Ganieva
Russian Federation
Moscow
M. A. Pigalitsyna
Russian Federation
Moscow
S. L. Dzemeshkevich
Russian Federation
Doctor of Medical Sciences, Professor, Scientific Director of the Division of Surgical Treatment of Myocardial Dysfunction and Heart Failure
Moscow
References
1. Gabrusenko SA, Gudkova AYa, Koziolova NA, et al. Hypertrophic cardiomyopathy. Clinical guidelines 2020. Russian Journal of Cardiology. 2021;26(5):4541. (In Russ.) doi:10.15829/1560-4071-2021-4541.
2. Arbelo E, Protonotarios A, Gimeno JR, et al. ESC Guidelines for the management of cardiomyopathies. Eur Heart Journal. 2023;44(37):3503-626. doi:10.1093/eurheartj/ ehad194.
3. Lutokhina YuA, Blagova OV, Kogan EA, et al. Prevalence of myocarditis and its contribution to the course of the disease in patients with primary myocardial hypertrophy syndrome. Russian Journal of Cardiology. 2023;28(11):5528. (In Russ.) doi:10.15829/1560-40712023-5528.
4. Delgado V, Marsan NA, Waha S, et al. ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM). European Heart Journal. 2023;44(39):3948-4042. doi:10.1093/eurheartj/ehad193.
5. Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30(4):633-8. doi:10.1086/313753.
6. Dominguez F, Ramos A, Bouza E, et al. Infective endocarditis in hypertrophic cardiomyopathy: A multicenter, prospective, cohort study. Medicine (Baltimore). 2016;95(26): e4008. doi:10.1097/MD.0000000000004008.
7. Thornhill MH, Jones S, Prendergast B, et al. Quantifying infective endocarditis risk in patients with predisposing cardiac conditions. Eur Heart J. 2018;39(7):586-95. doi:10.1093/eurheartj/ehx655.
8. Spirito P, Rapezzi C, Bellone P, et al. Infective endocarditis in hypertrophic cardiomyopathy: prevalence, incidence, and indications for antibiotic prophylaxis. 1999;99(16): 2132-7. doi:10.1161/01.cir.99.16.2132.
9. Dzemeshkevich SL. Cardiac surgery. The level of evidence is expert. MEDpress-inform, 2024. 344 р. (In Russ.) ISBN: 978-5-907760-67-7.
10. Oberoi M, Schaff HV, Nishimura RA, et al. Surgical Management of Hypertrophic Cardiomyopathy Complicated by Infective Endocarditis. Ann Thorac Surg. 2022;114(3): 744-9. doi:10.1016/j.athoracsur.2022.01.016.
Supplementary files
- Patients with hypertrophic cardiomyopathy have an increased risk of infective endocarditis.
- Optimal choice of surgical scope in a patient with a combination of obstructive hypertrophic cardiomyopathy and infective endocarditis is important for long-term disease outcomes.
- Comprehensive treatment and timely diagnosis of infective endocarditis contribute to a favorable prognosis.
Review
For citations:
Lutokhina Yu.A., Osadchaya V.A., Morozova N.V., Chichkova N.V., Ganieva N.A., Pigalitsyna M.A., Dzemeshkevich S.L. Severe infective endocarditis in a patient with hypertrophic obstructive cardiomyopathy: 12 years after combined surgery. A case report. Russian Journal of Cardiology. 2024;29(10S):6076. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6076. EDN: LVUBIY