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Atypical malignant late infective endocarditis of Melody valve

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1 Atypical malignant late infective endocarditis of Melody valve
Mehul Patel, MD, Laurence Iserin, MD, Damien Bonnet, MD, PhD, Younes Boudjemline, MD, PhD  The Journal of Thoracic and Cardiovascular Surgery  Volume 143, Issue 4, Pages e32-e35 (April 2012) DOI: /j.jtcvs Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 Ex vivo images of right ventricular outflow tract specimen of patient 1. The bare metal stent has been retrieved and is not shown. A, The explanted Melody valve with very large vegetation completely filling the cusps. B, Image of the sessile vegetation. C, Appearance of the prosthetic valve leaflets after removal of the vegetation. The Journal of Thoracic and Cardiovascular Surgery  , e32-e35DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 A, Ex vivo x-ray image of the conduit from patient 3 showing well-preserved frame of the bare metal stent struts with no fracture or collapse. B, Macroscopic examination of the slit open right ventricular outflow tract specimen showing the large vegetations filling up 2 of 3 cusps. The Journal of Thoracic and Cardiovascular Surgery  , e32-e35DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Histologic appearance of vegetation from patient 3; voluminous acellular thrombus (A) and extensive stuffing of polymorphonuclear neutrophils (B). The Journal of Thoracic and Cardiovascular Surgery  , e32-e35DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Proposed pathophysiologic mechanism for infective endocarditis of the Melody valve. PV, Pulmonary valve; NBTE, nonbacterial thrombotic endocarditis; PPVI, percutaneous pulmonary valve insertion; PVE, prosthetic valve endocarditis; MOF, multiorgan failure. The Journal of Thoracic and Cardiovascular Surgery  , e32-e35DOI: ( /j.jtcvs ) Copyright © 2012 The American Association for Thoracic Surgery Terms and Conditions

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