{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T10:05:12Z","timestamp":1768385112878,"version":"3.49.0"},"reference-count":16,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006109","name":"VEGA","doi-asserted-by":"crossref","award":["1\/0700\/23"],"award-info":[{"award-number":["1\/0700\/23"]}],"id":[{"id":"10.13039\/501100006109","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The Ross procedure provides excellent outcomes in young adults requiring aortic valve replacement, with lower rates of infective endocarditis (IE) compared to prosthetic valves. Early postoperative IE of the autograft is exceptionally rare, with only isolated cases reported in major registries. Case Summary: We report a 40-year-old man with bicuspid aortic valve and a history of two previous episodes of native valve endocarditis who underwent Ross procedure with Ozaki modification. Ten days postoperatively, he developed fever and was diagnosed with early autograft IE with perivalvular abscess formation. Despite negative blood cultures (due to prior antibiotic administration), clinical findings met modified Duke criteria for possible IE. Imaging revealed perivalvular abscess with subsequent pseudoaneurysm development, while the autograft leaflets remained functional. The patient was successfully treated with 6-week combination antibiotic therapy without requiring surgical reintervention. After one year of follow-up, he remains asymptomatic with stable pseudoaneurysm size and preserved valvular function. Conclusions: Early IE following Ross procedure, though rare, should be considered in patients presenting with postoperative fever. This case demonstrates that conservative management with appropriate antibiotic therapy can be successful even with perivalvular complications, provided there is hemodynamic stability and close multidisciplinary monitoring. Long-term surveillance remains essential given the persistent structural abnormalities.<\/jats:p>","DOI":"10.3390\/jcm15020611","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T12:44:44Z","timestamp":1768221884000},"page":"611","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Aortic Autograft Infective Endocarditis with Perivalvular Abscess Following the Ross Procedure"],"prefix":"10.3390","volume":"15","author":[{"given":"Peter","family":"Snopek","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty Hospital, 950 01 Nitra, Slovakia"},{"name":"Faculty of Social Sciences and Health, University of Constantin the Philosopher, 949 01 Nitra, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5922-5958","authenticated-orcid":false,"given":"\u0160tefan","family":"Luka\u010d\u00edn","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, Faculty of Medicine, University of Pavol Jozef \u0160af\u00e1rik and East Slovak Institute of Cardiovascular Diseases, 040 11 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid","family":"Schusterov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Imaging Techniques, Faculty of Medicine, University of Pavol Jozef \u0160af\u00e1rik and East Slovak Institute of Cardiovascular Diseases, 040 11 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9390-7191","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Koles\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Heart Surgery, Faculty of Medicine, University of Pavol Jozef \u0160af\u00e1rik and East Slovak Institute of Cardiovascular Diseases, 040 11 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozef","family":"Hasilla","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty Hospital, 950 01 Nitra, Slovakia"},{"name":"Faculty of Social Sciences and Health, University of Constantin the Philosopher, 949 01 Nitra, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Milan","family":"Kla\u010dansk\u00fd","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty Hospital, 950 01 Nitra, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavol","family":"F\u00fcl\u00f6p","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, Faculty of Medicine, University of Pavol Jozef \u0160af\u00e1rik and East Slovak Institute of Cardiovascular Diseases, 040 11 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6946-3765","authenticated-orcid":false,"given":"Tibor","family":"Porub\u00e4n","sequence":"additional","affiliation":[{"name":"1st Department of Cardiology, Faculty of Medicine, University of Pavol Jozef \u0160af\u00e1rik and East Slovak Institute of Cardiovascular Diseases, 040 11 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9789-3305","authenticated-orcid":false,"given":"\u0160tefan","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Department of Gerontology and Geriatrics, Faculty of Medicine, Pavol Jozef \u0160af\u00e1rik University\u2014University Hospital of St. Michael, Murga\u0161ova 1, 040 86 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Dvoro\u017e\u0148\u00e1kov\u00e1","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, Faculty of Medicine, University of Pavol Jozef \u0160af\u00e1rik and East Slovak Institute of Cardiovascular Diseases, 040 11 Ko\u0161ice, Slovakia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/S0140-6736(67)90794-5","article-title":"Replacement of aortic and mitral valves with a pulmonary autograft","volume":"290","author":"Ross","year":"1967","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1093\/ejcts\/ezaa078","article-title":"The Ross procedure is a safe and durable option in adults with infective endocarditis: A multicentre study","volume":"58","author":"Chauvette","year":"2020","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0140-6736(10)60828-8","article-title":"Long-term outcomes after autograft versus homograft aortic root replacement in adults with aortic valve disease: A randomised controlled trial","volume":"376","author":"Eryigit","year":"2010","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1253\/circj.CJ-14-1092","article-title":"Aortic valve reconstruction using autologous pericardium for aortic stenosis","volume":"79","author":"Ozaki","year":"2015","journal-title":"Circ. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1161\/CIRCULATIONAHA.107.726349","article-title":"The Ross procedure: A systematic review and meta-analysis","volume":"119","author":"Takkenberg","year":"2009","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"ezad117","DOI":"10.1093\/ejcts\/ezad117","article-title":"Autograft reoperations after the Ross procedure","volume":"63","author":"Abeln","year":"2023","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.jacc.2021.11.057","article-title":"Propensity-Matched Comparison of the Ross Procedure and Prosthetic Aortic Valve Replacement in Adults","volume":"79","author":"Toyoda","year":"2022","journal-title":"J. Am. Coll. 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Ultrasound"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"2023 ESC Guidelines for the management of endocarditis","volume":"44","author":"Delgado","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_12","first-page":"2324709620969478","article-title":"Infective Endocarditis 2 Decades After Pulmonary Autograft Ross Procedure","volume":"8","author":"Boyer","year":"2020","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.jacc.2021.12.026","article-title":"Improved Outcomes Following the Ross Procedure Compared With Bioprosthetic Aortic Valve Replacement","volume":"79","author":"Mazine","year":"2022","journal-title":"J. Am. Coll. 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Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/611\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T05:18:24Z","timestamp":1768367904000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020611"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020611","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]}}}