8.2 Pulmonary valve (PV)

RSIE in PV happens in less than 10% of the patients [7]. Most of the cases of pulmonary valve infective endocarditis (PVIE) are provoked by prosthetic material present at this place due to previous surgeries or interventional procedures focused on figuring a congenital disease out.

Bovine jugular grafts are associated with a significantly higher risk of late endocarditis compared with homografts [39].

However, Robichaud et al. did not find an increased risk of PVIE regarding the type of valve, including bovine jugular vein grafts [40].

The rate of IE in transcatheter pulmonary valve implantation is higher than surgical homograft implantation [41].

#### 8.3 Other sites

Uniquely few case reports have been published about RSIE in other locations different to tricuspid and pulmonary valves.

#### 8.3.1 Eustachian valve

Reports of eustachian valve infective endocarditis (EVIE) are approximately 29 cases [43]. An incidence of 3.3% in patients with right-sided endocarditis has been reported [44].

Eustachian valve is a rudimentary structure in adults and, during fetal life, directs oxygenated blood from the inferior vena cava through the foramen ovale and into the left atrium [43, 45].

IVDA is the main high-risk population to develop an EVIE (over 50% of cases). Staphylococcus aureus is the most common bacteria implicated in this process [43]. TOE is necessary to identify the vegetation at eustachian valve because this structure is not accessible with TTE [45].

#### 8.3.2 Coronary sinus

There are only eight reported cases of IE in the coronary sinus (CS). The clinical manifestations, the complementary test, the responsible bacteria, and antibiotic treatment are very similar to the other RSIE locations. The CSIE has some features; the CS is always dilated and generally the only affected valve; the vegetation is usually mobile and has a tubule shape with a length of >10 mm [9, 46].

#### 9. Conclusions

RSIE is a pathology scarcely studied because there are few articles released about it. One of the significant reasons about the RSIE little information is the low incidence of this disease; nevertheless, the rates of frequency of this infection are rising nowadays due to the steady increase of HD patients and implanted ICD.


#### Conflict of interest

None.

Right-Sided Infective Endocarditis DOI: http://dx.doi.org/10.5772/intechopen.85019
