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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">97</journal-id>
      <journal-id journal-id-type="index">urn:lsid:arphahub.com:pub:B5033382-9D21-53CE-B630-B4E3A1146D51</journal-id>
      <journal-title-group>
        <journal-title xml:lang="en">Bulgarian Cardiology</journal-title>
        <abbrev-journal-title xml:lang="en">Bulgarian Cardiology</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">1310-7488</issn>
      <issn pub-type="epub">2683-1015</issn>
      <publisher>
        <publisher-name>Bulgarian Society of Cardiology</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3897/bgcardio.28.e81189</article-id>
      <article-id pub-id-type="publisher-id">81189</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Case Report</subject>
        </subj-group>
        <subj-group subj-group-type="scientific_subject">
          <subject>Cardiosurgery (кардиохирургия)</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Therapeutic options in the treatment of infectious endocarditis of an implantable cardiac device lead</article-title>
      </title-group>
      <contrib-group content-type="authors">
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Ivanov</surname>
            <given-names>M.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="yes">
          <name name-style="western">
            <surname>Peneva</surname>
            <given-names>M.</given-names>
          </name>
          <email xlink:type="simple">milapeneva1@gmail.com</email>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Ivanov</surname>
            <given-names>I.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Gotcheva</surname>
            <given-names>N.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
        <contrib contrib-type="author" corresp="no">
          <name name-style="western">
            <surname>Boyadzhiev</surname>
            <given-names>L.</given-names>
          </name>
          <xref ref-type="aff" rid="A1">1</xref>
        </contrib>
      </contrib-group>
      <aff id="A1">
        <label>1</label>
        <addr-line content-type="verbatim">National Heart Hospital, Sofia, Bulgaria</addr-line>
        <institution>National Heart Hospital</institution>
        <addr-line content-type="city">Sofia</addr-line>
        <country>Bulgaria</country>
      </aff>
      <author-notes>
        <fn fn-type="corresp">
          <p>Corresponding author: M. Peneva (<email xlink:type="simple">milapeneva1@gmail.com</email>).</p>
        </fn>
        <fn fn-type="edited-by">
          <p>Academic editor: Nikolay Runev</p>
        </fn>
      </author-notes>
      <pub-date pub-type="collection">
        <year>2022</year>
      </pub-date>
      <pub-date pub-type="epub">
        <day>20</day>
        <month>06</month>
        <year>2022</year>
      </pub-date>
      <volume>28</volume>
      <issue>2</issue>
      <fpage>116</fpage>
      <lpage>122</lpage>
      <uri content-type="arpha" xlink:href="http://openbiodiv.net/E2DD9879-FCF5-5A59-90DB-2FDC381804A7">E2DD9879-FCF5-5A59-90DB-2FDC381804A7</uri>
      <history>
        <date date-type="received">
          <day>31</day>
          <month>01</month>
          <year>2022</year>
        </date>
        <date date-type="accepted">
          <day>19</day>
          <month>03</month>
          <year>2022</year>
        </date>
      </history>
      <permissions>
        <copyright-statement>M. Ivanov, M. Peneva, I. Ivanov, N. Gotcheva, L. Boyadzhiev</copyright-statement>
        <license license-type="creative-commons-attribution" xlink:href="http://creativecommons.org/licenses/by/4.0/" xlink:type="simple">
          <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
        </license>
      </permissions>
      <abstract>
        <label>Abstract</label>
        <p>Right-sided endocarditis, and endocarditis of the tricuspid valve in particular, is a relatively uncommon condition, encountered in approximately 5 to 10 percent of all cases of infectious endocarditis (IE). The recent increase in the prevalence of right-sided IE is attributed to intravenous drug abuse as well as the increased utilization of implantable cardiac devices such as pacemakers, implantable cardioverter-defi brillators, and cardiac resynchronization therapy devices. These cases pose signifi cant therapeutic challenges, especially when right-sided devices are involved. We present a case of 45-year-old male patient with proven IE with involvement of the tricuspid valve and implantable cardiac device lead and demonstrate the results of an antibacterial treatment and surgical interventions carried out in two steps – explanation of the lead of the implantable cardiac device, excision of the tricuspid valve, and implantation of an epicardial implantable device; subsequent tricuspid valve replacement with mechanical valve, surgical revascularization, and fi nally replacement of the thrombosed mechanical valve with a biological valve. The optimal preoperative management and the following comprehensive surgical intervention resulted in resolution of IE as it has been demonstrated by the lack of recurrence of systemic infl ammatory response syndrome and no further hospitalisations due to cardiovascular events.</p>
      </abstract>
    </article-meta>
  </front>
</article>
