Robotic Surgery for Mastitis Complicated With Tricuspid Valve Infective Endocarditis: Case Report

Tricuspid Valve Infective Endocarditis (TVIE) is less common than left-sided infective endocarditis. Nevertheless, mastitis may be complicated with TVIE. Valve repair should be considered in this situation due to high probability of Methicillin resistant Staphylococcus aureus vegetation. By robotic surgery, postoperative recovery is expected to be rapid owing to the small surgical wound.

Tricuspid Valve Infective Endocarditis (TVIE) accounted for 5% to 10% of infective endocarditis. The researches of TVIE are increasing due to intravenous drug abusers are more often seen in healthcare settings. However, TVIE caused by mastitis is extremely rare.

According to the definition by the World Health Organization (WHO), mastitis refers to as an inflammatory condition of the breast, possibly accompanied by infection and usually associated with lactation. Mastitis often occurs in postpartum women. Once abscesses form in mastitis, generally surgical incision and drainage are required.

In a joint study conducted by National Yang Ming University Hospital and Heping Fuyou Branch of Taipei City Hospital, it was found that 88% of mastitis in Taiwan was caused by Staphylococcus aureus. In which, more than half of them are Methicillin Resistant Staphylococcus Aureus (MRSA). According to a study, 77% of patients can be cured from ultrasound-guided drainage without surgery. It is important to conduct health education to prevent patients from mastitis-associated complications. Once mastitis is complicated with TVIE, profound bacteremia and cardiac valve damage will be frequently accompanied. Early surgical valve repair is necessary to be considered due to Methicillin resistant Staphylococcus aureus are often seen. By robotic surgery, rapid postoperative recovery is expected due to the small surgical wound.