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The Journal of Thoracic and Cardiovascular Surgery, Vol 72, 28-32, Copyright © 1976 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Prosthesis endocarditis: treatment of a case occurring five years after a Rastelli-Ross operation

J Thompson, T Dirksen, M Nube and AG Brom

A severe staphylococcal septicemia originating from an unknown focus occurred in a 17-year-old patient who had undergone a Rastelli-Ross operation 5 years earlier. The clinical course was complicated by extensive bilateral pneumonia, diffuse intravascular coagulation, and glomerulonephritis. After 4 weeks of intensive conservative treatment, including a daily regimen of 16 Gm. of cloxacillin, the patient was operated upon for a rapidly progressive false aneurysm, which had resulted from dehiscence of the anastomosis between the prosthesis and ventricle. The excised prosthesis proved to be sterile. The postoperative course was uneventful. Cloxacillin treatment was continued for 6 months, initially parenterally and later orally. After discontinuation of therapy, no signs of infection have occurred. Right- sided intracardiac or intravascular prosthetic material may be particularly susceptible to infections originating from the body surface.