Simultaneous Tricuspid and Pulmonic Valve Replacement Due to Infective Endocarditis

Right-sided valvular infective endocarditis (RSIE) is often associated with intravenous (IV) drug abuse and typically involves the tricuspid valve. The involvement of both the tricuspid and pulmonic valves is a rare entity. A 39-year-old woman presented with fever, dyspnea on exertion, and chest pain. She was subsequently found to have infectious endocarditis (IE) with the involvement of both the tricuspid and pulmonic valves. Simultaneous tricuspid and pulmonic valvular repair with bioprosthetic valves were performed with bovine pericardium to reconstruct the anterior surface of the pulmonary artery. Recovery was complicated by the development of a complete atrioventricular (AV) block requiring pacemaker implantation. Following device placement, the patient also developed two episodes of ventricular tachycardia arrest likely precipitated by the device. Return of spontaneous circulation (ROSC) was achieved and no further episodes occurred once the device was exchanged with a cardiac resynchronization therapy defibrillator. The patient improved clinically and was discharged home with no further complications.