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Late prosthetic valve endocarditis is usually due to community-acquired microorganisms. [17] Prosthetic valve endocarditis is commonly caused by Staphylococcus epidermidis as it is capable of growing as a biofilm on plastic surfaces. [18] Cutibacterium acnes almost exclusively causes endocarditis on prosthetic heart valves. [15]
The mitral valve is typically affected, and the vegetations occur on the ventricular and atrial surface of the valve. [5] Though the left-sided heart valves (mitral and aortic) are most commonly affected, any heart valve as well as adjoining structures may become involved.
Nonbacterial thrombotic endocarditis (NBTE) is a form of endocarditis in which small sterile vegetations are deposited on the valve leaflets. Formerly known as marantic endocarditis , which comes from the Greek marantikos , meaning "wasting away". [ 1 ]
Underlying structural valve disease is usually present in patients before developing subacute endocarditis, and is less likely to lead to septic emboli than is acute endocarditis, but subacute endocarditis has a relatively slow process of infection and, if left untreated, can worsen for up to one year before it is fatal.
Endocarditis is an inflammation of the inner layer of the heart, the endocardium.It usually involves the heart valves.Other structures that may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or the surfaces of intracardiac devices.
Endocarditis of the valves can lead to regurgitation through that valve, which is seen in the tricuspid, mitral, and aortic valves. [16] Certain medications have been associated with valvular heart disease, most prominently ergotamine derivatives pergolide and cabergoline .
The most common causes are myxomatous degeneration (Barlow disease), ischemic heart disease, dilated cardiomyopathy, rheumatic valve disease, mitral annular calcification, infective endocarditis, congenital anomalies, endocardial fibrosis, myocarditis, and collagen-vascular disorders. [7]
During open heart surgery for another issue (e.g. mitral valve), fixing the tricuspid valve may be considered, but medical consensus is unclear. Some argue that even mild to moderate tricuspid regurgitation should be addressed, while others take a more conservative approach. Infective endocarditis or traumatic lesions are other indications. [14]
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