Endocarditis at Prior Venous Cannulation Site after Sternal Wound Infection: Case Report

Abstract

Endocarditis originating from a prior venous cannulation site is undescribed in the current literature. Infections of the heart pose significant morbidity and mortality to patients, therefore prompt recognition, diagnosis, and treatment are critical. Our patient underwent coronary artery bypass grafting (CABG) and developed a postoperative sternal wound infection with methicillin resistant staphylococcus aureus (MRSA). After failing nonoperative management, redo-sternotomy was performed with atrial wall debridement and patch repair. During this procedure, two unexpected small discrete abscess pockets of the right atrial epicardium were discovered. One of the abscess pockets fistulized into the right atrium and was noted to be at his prior venous cannulation site for cardiopulmonary bypass as evidenced by neighboring prolene suture. The patient had an uneventful recovery and was discharged home on postoperative day 7. Transthoracic echo was obtained 6 weeks after his second operation and did not show any recurrence of endocarditis. We present a unique case of persistent cardiac infection with a complicated course and management strategy.