Ravi Korabathina*, Sophia Ciaravino, Steven V Curiale and Hugh M van Gelder
Bacterial endocarditis resulting from Enterococcus durans is rarely reported, but when present is generally
associated with favorable prognosis. We present the first report of a young male without pre-existing cardiac
conditions who developed respiratory failure and hemodynamic instability related to double valve E. durans
endocarditis. Following emergent valve surgery, he developed post-cardiotomy shock that was successfully bridged
to recovery using extracorporeal membranous oxygenation therapy. We describe the exhaustive post-operative
work-up to identify the etiology for post-cardiotomy shock, and speculate that the patient developed sepsis-related
cardiomyopathy immediately following surgery with new marked depression in left ventricular contractility that
completely normalized with left ventricular support. After comprehensive literature review consisting of only seven
other reports of E. durans endocarditis, this report questions the previously held notions regarding the low-virulence
characteristics of this particular Enterococcal species. Furthermore, in scenarios where salvage therapy for postcardiotomy
shock becomes necessary following emergent valve surgery for bacterial endocarditis, the importance of
having access to left ventricular assist devices is emphasized.