European Heart Journal - Case Reports 2018-Jun
A rare late finding in corrected tetralogy of Fallot: a case report.
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Case presentation
We describe a 37-year-old man with a previously implanted biologic pulmonary prosthesis after a TOF correction that presented to the emergency department with new-onset fever, orthopnoea, and lower limb oedema. Blood cultures were positive for Streptococcus mitis. Transthoracic echocardiography showed a large mobile mass in the right ventricular outflow tract, apparently originating from the pulmonary prosthesis. Transoesophageal echocardiography (TOE) showed the presence of multiple mobile structures arising from the arterial surface of the prosthesis, extending into the right pulmonary artery and causing right ventricular obstruction. Antibiogram guided treatment was administered and surgery was performed, removing a 9 cm vegetation and replacing the valve. Patient recovered well and was discharged 35 days after.