In the surgical treatment for active
infective endocarditis (IE), perivalvular leakage is the most severe complication. We had a 42-year-old man who had active IE and a giant vegetation in the aortic valve, and a small
mycotic aneurysm in the left ventricular outflow tract. Other operative observations included slight redness and a decrease in the reflex of the annular endocardium. We made a patch closure of the
mycotic aneurysm, and aortic valve replacement using the
Teflon felt reinforcing method. In the postoperative course, he had a pacemaker implantation with complete
AV block. Postoperative pathological examination revealed inflammatory cells and plasma infiltration, and edematous change of the interstitial tissue around the cusp surface and annular side of the resected valve. These pathological changes could explain the redness and the decrease in the reflex of the annular endocardium. The edematous changes of the annular tissue might be the cause of postoperative perivalvular leakage. Reinforcement of the prosthetic valve with
Teflon felt might be a useful method to prevent perivalvular leakage. There is, however, the possibility of acceleration or elongation of
infective endocarditis. In our experiences of the surgical treatment for active IE, we performed valve replacement using
Teflon felt in 6 patients, and not using in 27 patients. The mean period until CRP had been normalized was no significant difference between both groups (mean days using
Teflon felt were 63.5 days, and not using were 75 days).(ABSTRACT TRUNCATED AT 250 WORDS)