Takayama T, Irisawa A, Tanaka K, Nishiguchi K, Tominaga S, Ishihara A, Suwa T, Kuwao S
Kyobu Geka. 1989 Feb;42(2):160-3.
A 14-year-old boy had previously received right temporal lobectomy under the diagnosis of a malignant brain tumor. About one month after lobectomy, ventriculo-peritoneum shunt and ventriculo-atrium shunt were placed because hydrocephalus was progressed. The patient subsequently had a high fever probably due to wound infection of the shunt operation. Several blood cultures demonstrated Methicillin Resistant Staphylococcus Aureus (MRSA). Several sensitive antibiotics were administered for about 30 days, however these drugs were not effective. According to echocardiography, moderate tricuspid regurgitation and a large vegetation at the tricuspid valve were detected and isolated tricuspid valve endocarditis was diagnosed. Surgical intervention was necessary because of recurrent pulmonary emboli. After tricuspid valve replacement with a Björk-Shiley mechanical valve (31 mm), fever subsided and the patient was discharged on the 38th postoperative day. It is concluded that the surgical indications of the tricuspid valve endocarditis are as follows: 1. recurrent pulmonary emboli, 2. refractory right heart failure, 3. resistance against antibiotics.
