A Devastating Separation

Endocarditis is a rare complication following surgical placement of prosthetic valves, especially within the first 3 months following the procedure. Endocarditis increases the incidence of valve replacement failures and occurrences of prosthetic valve dehiscence. The nature of dehiscence can be either partial or complete, with complete dehiscence less commonly outlined within the literature. We present a case of a 69-year-old man who died suddenly during treatment for endocarditis ∼2 months following aortic valve replacement. The patient had an initial aortic valve replacement and required a second surgery for the placement of a revisional valve nearly 4 years later. The patient died in the hospital 2 months following the second valve procedure from prosthetic valve endocarditis. Antemortem blood cultures grew Staphylococcus epidermidis. Autopsy findings confirmed bacterial infection of the bovine aortic valve prosthesis, valve annulus, and myocardium. Complete dehiscence of the prosthetic valve was found with embolization of the valve to the abdominal aorta. This case illustrates the presentation and autopsy findings of a case of sudden death due to embolization of a prosthetic aortic valve. Understanding the pathology and comorbidities associated with bacterial endocarditis is important in the evaluation of such cases.