Yamamoto K, Shinonaga M, Takeda F, Tanaka S, Matsubara H, Oguma F, Kasuya S
Department of Cardiovascular Surgery, Tachikawa Medical Center, Nagaoka, Japan.
Kyobu Geka. 2002 Aug;55(9):807-10.
A 67-year-old man, who had been performed aortic and mitral valve replacement 3 years before, was admitted because of appetite loss, general fatigue and anemia. Although transthoracic echocadiogram showed no evidence of prosthetic valves failure, the patient fell in profound shock. He needed endotracheal intubation and inotropic support. Transesophageal echocadiogram revealed vegetation formation on the prosthetic mitral valve and massive periprosthetic valve leakage. The diagnosis of prosthetic valve endocarditis was established. Blood examination showed severe disseminated intravascular coagulation (DIC). The patient underwent re-mitral valve replacement and recovered well from shock and DIC.
一名67岁男性,3年前接受了主动脉瓣和二尖瓣置换术,因食欲减退、全身乏力和贫血入院。尽管经胸超声心动图未显示人工瓣膜功能障碍的证据,但患者陷入了严重休克。他需要气管插管和使用血管活性药物支持治疗。经食管超声心动图显示人工二尖瓣上有赘生物形成,且人工瓣膜周围有大量渗漏。确诊为人工瓣膜心内膜炎。血液检查显示严重的弥散性血管内凝血(DIC)。该患者接受了再次二尖瓣置换术,休克和DIC均恢复良好。