XXXX Involving the Pulmonary Valve.

@entity1 @entity944 @entity797 @entity299 @entity884
Pulmonary valve (PV) @entity884 ( @entity884 ) is a rare entity, accounting for 1.5% to 2% of cases of @entity884 . Published data are limited to a few case series and reports. We sought to review the Mayo Clinic experience and describe clinical, echocardiographic, and microbiologic features. We included all @entity1 aged >= 18  years seen from 2000 to 2014 who had a diagnosis of native PV @entity884 and unequivocal echocardiographic involvement of the PV. Nine @entity1 with PV @entity884 were identified. Isolated PV @entity884 was present in 7 (78%) of 9 cases. The median age was 59  years and 22% were @entity1 . Three @entity1 had @entity299 , 2 had central venous catheters, and 3 had cardiovascular implantable electronic devices. Five @entity1 (56%) received chronic immunosuppressive therapy. @entity797 and viridans group streptococci were the most common pathogens, isolated in 22% of cases each. Transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE) were done in 6 and 7 @entity1 , respectively. Four @entity1 underwent both procedures. TTE was diagnostic in all cases, but TEE failed to detect PV involvement in 1 @entity1 . Median follow-up was 1.8  years. Five @entity1 (56%) underwent PV replacement. There were no operative deaths. One @entity1 had @entity944 during follow-up, unrelated to his PV @entity884 episode. Our results suggest that PV @entity884 is rare but carries significant morbidity. TTE and TEE provide complementary information with TEE providing better visualization of other @entity299 . Our findings of a high prevalence of immunosuppressive therapy and cardiovascular implantable electronic devices have not been previously reported and deserve further investigation.
