Asai T, Ichikawa S, Usui M, Hirate Y, Miyata Y
Department of Thoracic and Cardiovascular Surgery, Nagoya Ekisaikai Hospital, Japan.
Kyobu Geka. 1999 May;52(5):408-11.
The patient was a 51-year-old man with Marfan syndrome who had simultaneously undergone modified Bentall operation (Carrel patch method) and coronary artery bypass grafting. Prosthetic valve endocarditis (PVE) occurred 19 months after the operation. PVE had thereafter been treated by antibiotic therapy for 3 months, but echocardiography revealed prosthetic valve detachment and aortic root pseudoaneurysm ruptured into the right ventricle which appeared to have been caused by PVE. At reoperation there were no laboratory or intraoperative findings indicative of ongoing inflammation or infection. The composite graft, therefore, didn't require replacing, and it was possible to simply re-suture the composite graft and directly close the tear. The postoperative course has been uneventful with no further evidence of endocarditis.
该患者为一名51岁患有马凡综合征的男性，同时接受了改良Bentall手术（Carrel补片法）和冠状动脉旁路移植术。人工瓣膜心内膜炎（PVE）在术后19个月发生。此后，PVE接受了3个月的抗生素治疗，但超声心动图显示人工瓣膜脱离，主动脉根部假性动脉瘤破裂进入右心室，这似乎是由PVE引起的。再次手术时，没有实验室或术中发现表明存在持续炎症或感染。因此，复合移植物无需更换，可以简单地重新缝合复合移植物并直接封闭撕裂处。术后过程平稳，没有心内膜炎的进一步证据。
