Embolism of coronary, cerebral, and limb arteries resulting from infective endocarditis of a prosthetic aortic valve - a clinical case report

Sep 28, 2026

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Infective endocarditis involving prosthetic valves is a critical cardiac disorder that can damage cardiac structures, cause heart failure, and trigger arterial embolism with high mortality. This report presents an uncommon case in which infective endocarditis of a prosthetic aortic valve led to multiorgan embolism. The clinical course, diagnostic findings, and management sequence are described, emphasizing the need for timely recognition and coordinated antimicrobial and surgical decision-making.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

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Abstract

Background

Case presentation

Conclusion

Introduction

Prosthetic valve endocarditis overview

Cardiobacterium hominis and diagnosis rationale

Case presentation

Clinical presentation and history

Physical examination and initial investigations

Chen et al. BMC Cardiovascular Disorders (2026) 26:2 BMC Cardiovascular Disorders [https://doi.org/10.1186/s12872-025-05287-2](https://doi.org/10.1186/s12872-025-05287-2) CASE REPORT Open Access Embolism of coronary, cerebral, and limb arteries resulting from infective endocarditis of a prosthetic aortic valve: a clinical case report Yunxian Chen 1, Yuhua Hu 1, Haiyang Liang 1, Jue Xia 1, Liangqiu Tang 1 and Shebing Zhang 1* Abstract Background Infective endocarditis (IE) involving prosthetic valves is a critical cardiac condition that can lead to complications such as structural heart damage, heart failure, and arterial embolism, with a high associated mortality rate. This report describes an uncommon instance of infective endocarditis of a prosthetic aortic valve leading to multiorgan embolism. Case presentation A 52-year-old male with a history of Bentall surgery and prosthetic aortic valve replacement presented with chest pain and dyspnea. Coronary angiography demonstrated blockage of the distal left anterior descending artery, which was addressed with balloon angioplasty. A transesophageal echocardiogram (TEE) detected vegetation on the prosthetic valve, and metagenomic next-generation sequencing of blood confirmed infection with Cardiobacterium hominis. During treatment, he experienced acute ischaemia in the right lower limb necessitating thrombectomy, and MRI disclosed numerous tiny infarct foci in the brain. Following a period of six weeks of antibiotic treatment, the patient was discharged in a better condition. However, the valve dysfunction persisted and regular follow-up was required in order to determine whether to perform a further operation. Conclusion This case underscores the risk of multi-organ embol ic consequences in prosthetic valve infective endocarditis, highlighting the necessity for prompt identification, antimicrobial treatment, and surgical intervention where warranted. Keywords Prosthetic valve infective endocarditis, Acute myocardial infarction, Peripheral arterial embolism, Cardiobacterium hominis, Antibiotic prophylaxis *Correspondence: Shebing Zhang [rangomd@sina.com](rangomd@sina.com) 1Department of Cardiology, Yue Bei People’s Hospital, Shantou University Medical College, No. 133, Huimin South Road, Wujiang District, Shaoguan 512025, P. R. China © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/. Chen et al. BMC Cardiovascular Disorders (2026) 26:2 Introduction Prosthetic Valve Endocarditis (PVE) is a severe complication following aortic valve replacement, whether surgical or transcatheter [1]. The incidence of infective endocarditis (IE) is higher after surgical aortic valve replacement (SAVR) than after transcatheter aortic valve replacement (TAVR), with cumulative incidences at 60 months of 2.4% and 1.5%, respectively [2]. The most frequently isolated pathogens in PVE cases are staphylococci, streptococci, and enterococci [3]. Both TAVR and SAVR pat

FAQs

What complication can prosthetic valve infective endocarditis cause?

It can lead to severe complications including arterial embolism affecting multiple organs, as well as heart failure and structural heart damage.

How was the infection confirmed in the reported case?

A transesophageal echocardiogram identified vegetation on the prosthetic valve, and metagenomic next-generation sequencing of blood confirmed Cardiobacterium hominis.

What embolic events occurred during treatment?

The patient developed acute ischemia in the right lower limb requiring thrombectomy, and MRI showed numerous tiny infarct foci in the brain.

Sep 28, 2026

Uploaded by awa