Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Bacterial Endocarditis following Mitral Valve Replacement

Forum: The Heart Forum
Topic: Heart Disease


My Mom had mitral valve replacement last August (97) Almost immediately after her surgery the valve became horribly infected. My Mother was consequently unresponsive and unable to communicate with us. We were told at the time that she was reacting to the heavy dose of anesthesia and infection. My Mom spent 28 horrible days in the hospital and never came home with us.

It's over a year now and there are still questions in my mind. I recently got copies of the medical records and have been doing lots of my own research about bacterial endocarditis. It appears that my Mother was at great risk to get this infection due to the mitral valve regurgitation and other abnormalities in her heart. Most of my research states that there are preventitive measures that can be taken to fight the bacteria that causes this infection. Most suggest an aggressive dose of prophylaxis before the surgery and after. Much to my horror, I can't find any indication that this was done at the time of my Mother's surgery.
She was on several antibiotics days after the surgery, but in what appears to be small doses.

Please, if there is any more information you can give me about this I wold really appreciate it. I have found many good sites with great information, but have yet to find someone to actually discuss this with.

Thank-you!


Dear Kristine, thank you for your question. I hesitate to answer your question since you are asking sensitive questions regarding your mother’s care after her mitral valve replacement and I have limited information on her care and I was not one of the physicians caring for her. I will add a few points that may help. First, antibiotics are not commonly given before valve replacement surgery. You may be confusing antibiotic prophylaxis for non-cardiac procedures (dental work, genitourinary procedures, etc.) for patients at risk for endocarditis with the valve replacement procedure. Second, endocarditis does occur in the immediate post-operative period despite the best efforts of the physicians and flawless surgical techniques. Your mother may have been one of the unlucky patients who developed early post-operative endocarditis even with excellent medical care. Third, I suggest that you speak directly with her physicians regarding your questions because they may be able to alleviate some of your concerns



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