Dental Instrumentation Leading to Multivalvular Vegetation Endocarditis in an Otherwise Healthy Immunocompetent Patient Requiring Double Valve Replacement

牙科器械操作导致免疫功能正常的健康患者发生多瓣膜赘生物性心内膜炎,最终需要进行双瓣膜置换术

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Abstract

Infective endocarditis (IE) is a severe condition associated with significant morbidity and mortality, often caused by bacterial seeding. Dental procedures are a well-known and well-documented risk factor for this disease. The authors present a case involving an otherwise healthy 58-year-old male with no cardiac risk factors who developed IE following a dental crown preparation. The patient's dental-induced IE could not be managed medically due to bacterial abscess formation in the mitral and aortic valves. As a result, he developed both mitral and aortic valvopathies, characterized by mild mitral and severe aortic regurgitation, ultimately necessitating mitral valve and aortic valve replacement under cardiopulmonary bypass. This case report highlights the appropriate identification of IE, perioperative evaluation, intraoperative anesthetic management, and a review of echocardiographic findings. A heightened level of clinical awareness was critical for identifying this high-morbidity and high-mortality disease process. The report also reviews the full spectrum of diagnostic and therapeutic interventions in managing an otherwise healthy individual.

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