Pulmonary Valve Endocarditis in a Corrected Tetralogy of Fallot

Abstract

Tetralogy of Fallot is the most common cyanotic congenital heart disease. In the last decades, the number of adults with surgically corrected defects is increasing and we have to face with late complications. Echocardiography has a central role in the early diagnosis of these conditions. We report the case of a 31-year-old man, treated during childhood with surgical repair of the ventricular septal defect, ventricular right outflow plasty, and pulmonary valve commissurotomy. At the age of 30 years, the patient underwent a second surgical intervention (aortic root replacement and pulmonary bioprosthesis implantation). He was also affected by urethral stenosis and complained of relapsing urinary tract infections. At the admission to our department, he reported remittent fever ensued one month before. We performed a third surgical intervention (aortic and pulmonary valve replacement) after diagnosing Steptococcusagalactiae endocarditis involving the pulmonary prosthesis and the native aortic valve. In conclusion, echocardiographic follow-up and prevention of infection are the mainstays to improve the outcome of corrected congenital heart disease.