Bioprosthetic tricuspid valve replacement for tricuspid valve endocarditis secondary to infected endocardial pacemaker leads.

BACKGROUND: The purpose of this study was to present outcomes of bioprosthetic tricuspid valve replacement (TVR) in patients with tricuspid valve infective endocarditis (TVIE).

METHODS: From October 2001 to December 2015, 26 patients underwent a bioprosthetic TVR due to severe TVIE after endocardial pacemaker implantation.

RESULTS: Staphylococcus species and Streptococcus species were the predominant microorganisms. Early 30-day hospital mortality was 0 (0%). There were three late deaths (11.5%), none cardiac related. At nine years, freedom from cardiac death was 100%. Mean follow-up was 5.7 ± 4.1 years (range, 1.3-14.2 years). There were two cases (7.7%) of cardiac redo operations related to recurrent infection. At nine years, freedom from valve-related redo operation was 92.3%. There was no thrombosis-embolism, bleeding, or other valve-related events. No peri-valve leak or vegetation was seen on the last echocardiographic examination.

CONCLUSIONS: Bioprosthetic TVR can be performed with acceptable morbidity and mortality in severe tricuspid endocarditis due to infected endocardial pacemaker leads.