Radical surgical repair with stepwise Cabrol shunt for severe prosthetic valve endocarditis.

Prosthetic valve endocarditis involving other valves and cardiac structures requires complex surgical reconstruction, which is sometimes accompanied by uncontrollable bleeding. We report the case of a 41-year old man who developed prosthetic aortic valve endocarditis with paravalvular abscess affecting the intervalvular fibrous body, the mitral valve and other cardiac structures. Aortic root and mitral valve replacement with reconstruction of the intervalvular fibrous body led to torrential bleeding from the proximal aortic root anastomosis, which was successfully controlled by a stepwise Cabrol shunt.