JCCVS
Journal of Cardiology & Cardiovascular Surgery

Journal of Cardiology & Cardiovascular Surgery scientific, open-access, double-blind peer-reviewed journal covering a wide spectrum of topics in cardiology and cardiovascular surgery.

eISSN: 2980-1397
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Case Report
Surgical strategy to prevent moderate patient–prosthesis mismatch in infective endocarditis complicated by a narrow aortic root: a case report
Abstract
A 65-year-old male presented with fever, progressive dyspnea, bilateral lower-extremity edema, and new-onset angina. Transesophageal echocardiography and coronary computed tomography angiography revealed severe aortic and tricuspid regurgitation with large vegetations, moderate mitral regurgitation, a narrow aortic root, and critical stenoses of the left main and right coronary arteries. Blood cultures grew vancomycin-sensitive Enterococcus faecalis. The patient underwent urgent aortic and tricuspid valve replacement, mitral valve repair, and triple-vessel coronary artery bypass grafting. Because of the narrow aortic root, the Nicks procedure was performed to provide adequate prosthetic valve area and to prevent patient–prosthesis mismatch (PPM). This rare adult case emphasizes the importance of preoperative indexed effective orifice area (iEOA) calculations and highlights the role of Nicks, Manouguian, and Yang enlargement techniques in preventing PPM and managing complex left ventricular outflow tract pathology.

Keywords : Infective endocarditis, aortic root enlargement, patient–prosthesis mismatch, indexed effective orifice area, Nicks procedure

Download Article


1. Habib G, Lancellotti P, Antunes MJ, et al. 2023 ESC Guidelines for the management of infective endocarditis.<strong> </strong>Eur Heart J.<strong> </strong>2023;44(39):3948-4042. doi:10.1093/eurheartj/ehad193
2. Kahraman N, Binicier NA, Demir D. Reoperation for complete posterior annular detachment and rocking motion of a prosthetic mitral valve after infective endocarditis.<strong> </strong>Cardiovasc Revasc Med Interesting Cases<strong>. </strong>2025;10:100109. doi:10.1016/j.crmic.2025.100109
3. Kahraman N, Binicier NA. Konno-Rastan aortic root enlargement for late tunnel-type subaortic stenosis: a case report. Cardiovasc Revasc Med Interesting Cases. 2025;10:100118. doi:10.1016/j.crmic.2025.100118
4. Kahraman N, Binicier NA, Demir D. En bloc resection of a left atrial myxoma mimicking bronchial asthma: a case report. Cardiovasc Revasc Med Interesting Cases. 2025;10:100106. doi:10.1016/j.crmic.2025.100106
5. Yazdchi F, Monaghan K, Yang B. Aortic valve replacement with Y-incision/rectangular patch aortic annular enlargement. Indian J Thorac Cardiovasc Surg. 2023;39(Suppl 2):341-343. doi:10.1007/s12055-023-01606-4
6. Tam DY, Dharma C, Rocha RV, et al. Early and late outcomes following aortic root enlargement: a systematic review and meta-analysis. Ann Thorac Surg. 2022;114(4):1238-1246. doi:10.1016/j.athoracsur.2022.02.045
7. Fazmin IT, Ali JM. Prosthesis-patient mismatch and aortic root enlargement: indications, techniques, and outcomes. J Cardiovasc Dev Dis. 2023;10(9):373. doi:10.3390/jcdd10090373
Article available in :
Volume 4, Issue 2, 2026
Page : 48-50
https://doi.org/10.51271/JCCVS-0076
Article Information
Received : 03 Nis 2026
Accepted : 12 May 2026
Published : 08 Haz 2026
Corresponding Author :

Nöfel Ahmet Binicier: Department of Cardiovasculary Surgery, Bursa City Hospital, Bursa, Turkiye

[email protected]
Citation : Binicier NA, Kahraman N, Taner T, Coşkun M, Demir D. Surgical strategy to prevent moderate patient–prosthesis mismatch in infective endocarditis complicated by a narrow aortic root: a case report. J Cardiol Cardiovasc Surg. 2026;4(2):48-50. doi:10.51271/JCCVS-0076

Read: 216
Download : 199
Cited: 0
_Footer