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Successful Surgical Treatment of Q Fever Endocarditis with Mitral Valve Repair
  1. JN Khan1,
  2. LD Tapp1,
  3. JM Glancy1,
  4. N Prasad1,
  5. MS Bailey2 and
  6. Mr Timothy R Graham3
  1. 1Hereford County Hospital, Wye Valley NHS Trust, Hereford, England, UK
  2. 2Birmingham Heartlands Hospital,Birmingham, England, UK
  3. 3University Hospitals Birmingham NHS Trust, Birmingham, England, UK, B15 2TT, 0121 627 2541 0121 627 5736 tim.graham{at}uhb.nhs.uk

Abstract

We report a case of successful surgical treatment of Q fever endocarditis with mitral valve repair in a 66-year old retired British soldier. Valve replacement is invariably undertaken in Q fever endocarditis due to the degree of valvular damage and concerns about eradicating the organism, Coxiella burnetii. Our unique case allowed valve repair since pre-existing myxomatous degeneration and subsequent posterior mitral valve leaflet prolapse resulted in significant excess valve tissue, allowing quadrangular resection of the damaged and perforated P2 portion of this leaflet. Follow-up at four years (including three years of antibiotic treatment) has confirmed excellent valve repair, with no echocardiographic, clinical or microbiological evidence of recurrence. We are only the second group to describe valve repair in a patient with chronic Q fever endocarditis. Valve repair is preferable to valve replacement for Q fever endocarditis, if technically possible.

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