In 38 cases of prosthetic valve endocarditis, 19 were early cases (onset < 60 days after insertion of prosthesis) and 19, late cases (onset> 60 days). Nine late cases had onsets 12 to 53 months after surgery. The sources or predisposing factors in late cases included dental disease or manipulation; genitourinary tract procedures; and skin, urinary, or wound infections. In contrast, most early c...

1 of 2 DESCRIPTION A 29-year-old woman presented with pulmonary oedema and low cardiac output. Her mitral valve was replaced 20 years back with a Sorin mechanical valve. She had stopped anticoagulants a month back on her own for excessive menstrual bleeding. Echo showed a gradient of 26 mm Hg across the valve with regurgitation. Fluroscopy confi rmed limited disc opening of only 15° with incomp...