Homograft AVR & Aorta Replacement - Endocarditis infection of St. Jude's valve

[arc-weld]

Over this past 4th of July weekend, I came down with a fever of 104F. After a trip to ER and three trips to the family doctor over 4 days, they figured out that I had a Gram Positive staff infection.

On July 8th, I was hospitalized in Little Rock. I'd guess the Dr. pulled 18 blood cultures to insure they knew which bacteria I had. The IV antibiotics started then and did they flow.

On July 14, I was still severely septic and my mechanical aortic valve had a huge abscess under it. The thoracic surgeon felt we could not wait until the infection cleared to remove the valve.

The valve was replaced that day with a Homograph [which I never heard of] in Little Rock Baptist Health Hospital. I was kept on a ventilator for 5 days to keep my blood pressure LOW and monitor for bleeding.

The treatment for the infection was Penicillin G and Gentamicin. I got so much that is stalled my kidneys. My kidney function is still not normal. Its almost normal but not quite there.

Its been 5 weeks today and I feel good and continue to recover. The Doctors in Baptist Health Hospital saved my life.

I post this to help all those with a Mechanical Valve understand what could happen if you get endocarditis.

In addition, they replaced the valve with a Homograph human valve from a donor. This surgery is more rare and not performed just at any hospital. I was lucky.

If you know any information about a Homograph Valve or can tell me where to find it, I would sincerely appreciate it.

Thanks
Michael 46

 

[tprice54]

WOW! Thanks for posting so others may learn from your experience. I do not have a homograft, but I know many others here have, so hopefully they will see your post and join in. Hoping for a steady quick recovery for you!

 

[Lynlw]

Hi, Welcome. Yes BE is something that can be really dangerous, Thank you for sharing your story.
I'm glad they were able to diagnos the infection and see the abscess early enough, so operated right away. As you said they saved your life. Homograft valves used to be used alot more often, but as tissue valves from animals were improved, they get used alot, because it can be harder to get the human valves in the correct size etc. I normally don't mention anyones spelling, but wanted to menion it is homograft, since you've probably been doing searches and that might be why your having trouble finding any info about them.

 

[Mentu]

Michael, talk about a whirlwind experience! I am happy to hear that your doctors were able to control the infection and replace your valve. It is also very heartening to hear that after all of that and a second valve replacement you are now feeling well. I don't know a lot about homografts but my surgeon did say that today they were used primarily for patients at greater risk for endocarditis. I've included a link to a paper that discusses the problem you have experienced. In this study, 182 patients who suffered periannular abscesses received homograft aortic valves. Some of these were infections of the patients natural valve but almost half had infections associated with replacement valves. I hope this is helpful.

http://ejcts.ctsnetjournals.org/cgi/reprint/21/2/260

Larry

 

[piglet]

I found this for you
http://www.chdinfo.com/aa/aa061597.htm
I hope it helps

I too had endocarditis, mine was on my native aortic valve, now I have a bovine. reoccurance is my greatest fear as I'm on immunosuppressants and NSAIDS that mask any fever. The doctors assure me they are keeping a very close eye on me (blood tests weekly) but it's hard to get it out of my mind. I will say one thing though, the doctors heavily stress the importance of good oral hygene as dental proceedures are the most common cause of endocarditis.

 

[scott.eitman]

Glad to read that you are doing better. Pull a mechanical out is not something we think about much. Thanks for sharing this story. I did just the opposite, after my homograph hit its end of life.

I just did a google search on "homograh aortic" and found a ton. Good luck finding what you are looking for.

 

[jhammer]

Wow. Thanks for sharing. Scary times, for sure.

 

[Gail in Ca]

So glad you have come through all this and are doing well! After my endocarditis was treated for 6 wks, my doc decided my mech aortic and natural leaky mitral valves had been affected by the staph. So, at least I had some time before surgery. My surgeon explained before my surgery that he would replace my aortic with another mechanical unless there was too much damage from the bacteria, affecting my valves surrounding tissue and even my heart itself. If he couldn't use my existing aorta, he would've had to use a homograph which would've been the valve and the ascending aorta, and I think even a section of the heart, too. I would ask your surgeon if this was the case. Maybe, he wasn't able to just place another mech valve in there, due to the damage.

 

[arc-weld]

My AVR was replaced on 10/06/2005 with a St. Jude's mechanical type due to a leaking bicuspid valve in Pensacola FL.
I had no issues with the valve after installation.

The valve had a minor abscess under it on Friday 06/08/11 and by Wednesday 06/13/2011 the entire valve was sitting on an abscess.
The "TEE" probe kept shutting down due to my temperature being so high so abscess findings were sketchy on Friday.
Seems the probe kicks out at 108 and my core temp was 104.

The bacteria never attached to the valve's moving parts for some reason.

The surgeon felt the valve would come detached if we waited any longer as the abscess was undermining the valve.
My blood tests were a mess. My sugar levels went over 300, white count was way over normal, liver function was out of target also and my temperature was over 103 going into surgery.
Several days before surgery, my INR was 1.5 or less leading to a large increase in Coumadin intake to raise the INR value.
The doctors started plasma units to combat the Coumadin affect in addition to vitamin K injections.

In the end, the team of doctors saved my life some how.
The local community rallied around my family for support and prayers.
My wife is from heaven to be by my side every day for 30 days of the hospital stay.

 

[arc-weld]

I am still on a Penicillin G IV feed of 18 Million units a day. At some point I was getting 33 million units a day but kidney issue forced a reduction. I'll be on the IV feed for about 10 weeks post op. I have 27 days to go.... Every week they are ramping up the dose as my kidneys improve. I look forward to my 6 week checkup next week.