Bicuspid aortic valve and MRSA

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Submitted by Dr T on October 19, 2012 – 12:53pm

Question: 
Is it possible for MRSA to attack a bicuspid aortic valve, damage it so much hat a AVR is required, and yet not leave vegetative growth on the NAR?  Does MRSA always leave a detectable visible or microscopic growth on a damaged heart?

Hi Kathy,
MRSA (Methicillin Resistent Staphylococcus Aureus) endocarditis can destroy heart valves, especially ones that are abnormal such as a bicuspid valve or prosthetic valves. If the infection damages a heart valve, sometimes surgery is needed. However, a decision to operate on a heart valve depends on complications caused by the malfunction. The decision to operate on a damaged valve is depended on a lot of factors that especially include evidence the valve is involved and heart failure. Sometimes the infection can be managed by antibiotics alone.

In a patient with MRSA  there certainly would be a concern that a heart valve is or will become involved.  Tests (often many times repeated) include blood cultures for MRSA and cardiac ECHOS. Regarding your question, I have never seen a MRSA infected valve without lots of related abnormalities.

Hope this helps,
Dr T

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