Introduction A male infant was diagnosed and treated for Group B Streptococcus meningitis from day 10 of life after uncomplicated pregnancy and delivery. During this intravenous antibiotic treatment he presented with symptoms of heart failure. The diagnosis of infective endocarditis of the mitral valve with mixed pathology and impaired LV function was established on day 26 of life. His weight was 4kg at that time. On day 34 of life attempt of valve repair failed and 17mm mechanical prosthesis was implanted into mitral position. 2 subsequent bypass surgeries followed this initial operation on day 79 and 82 due to partially blocked prosthesis including re-do mitral valve replacement. Despite otherwise good clinical progression conversion from iv Heparin to Warfarin remained unsuccessful requiring several courses of thrombolysis due to repeated blockage of one leaflet of the prosthesis.
Treatment and Complication: The mechanical prosthesis was replaced with Melody valve 6 months after the initial and 4 months after the last surgery at a body weight of 7.4kg. The Melody valve was implanted by dilating it to 14mm under direct vision. Post bypass transoesophageal echocardiography showed a 4mm significant paravalvular leak (figure 1).
Result No significant leak after repeat balloon dilatation of the valve was detected (figure 2).
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.