A case report of aortic valve and VSD Dacron patch infective endocarditis after VSD patch closure 15 years ago

A 39-year-old man who had undergone the patch closure of the VSD 15 years ago, was admitted with a diagnosis of infective endocarditis due to Alcaligenes Xylosoxidans. Echocardiography revealed vegetation of the aortic valve and a high echoic lesion on the ventricular septum. Surgical findings showed vegetation of the aortic valve and a subannular type mycotic aneurysm. In the aneurysm, the infected pledget used in a previous surgery was found. After debridement, direct closure of the aneurysm, aortic valve replacement (AVR) using a #25 SJM prosthetic valve, and mitral annuloplasty were performed. Two months later, fever developed. The patient was diagnosed with prosthetic valve endocarditis and a second surgery was performed. The prosthetic valve was clear, but an infected Dacron patch used for VSD closure 15 years earlier was found. Debridement, patch closure of the ventricular septum, and re-AVR were performed. The post-operative course was uneventful. This is thought to be a rare case, because infection extended from the aortic valve to the VSD type II Dacron patch, and remained to the VSD type II Dacron patch.