Recurrent Aortic Prosthetic Valve Endocarditis: A Radical Additional Anatomical Solution.

Recurrent prosthetic valve endocarditis, especially when characterized by annular abscess and aortic root destruction, remains a surgical challenge. A radical and aggressive surgical treatment is required preventing recurrent infection. Homograft implants are still thought to be the best surgical option, but they are not always available and their use in younger patient remains controversial. We propose an additional anatomical surgical technique, which consists in the implantation of a composite graft in the left ventricular outflow tract, well below the native aortic annulus, and then the direct reimplantation of coronary ostia.