Reactivation of Endocarditis with Commitment of the Fibrosis Skeleton

Introduction: the fibrous skeleton endocarditis is a frequent complication of infective endocarditis. Its incidence varies depending on the series between 25 and 39% and doubles in prosthetic valve endocarditis. It is considered that mortality is 30% with conventional surgical management and recurrence of infection of 9.5%. Case: patient 40 years old who was admitted because of Table 3 months of occasional fever, night sweats, chest pain and weight loss; valuation is performed and positive cultures for gram positive cocci evidence. With echocardiogram report vegetated anterior leaflet of the mitral valve and aortic valve vegetation and severe mitral regurgitation. Antibiotic therapy is initiated with posterior mitral valve replacement and aortic mechanical. On the first postoperative month presents vegetation accompanied by severe mitral regurgitation again. Antibiotic therapy is initiated, and progression of failure, mitral valve eviction takes new mechanical mitral valve replacement and reconstruction of the ring. Postoperative control of the second valve replacement is asymptomatic. Conclusion: This is an important event for the revival of the fibrous skeleton endocarditis in the first month after surgery, which required a second change, more reconstruction of the mitral ring, adequate evolution.