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[采用自由式无支架瓣膜行主动脉根部置换术治疗感染性心内膜炎所致主动脉左心室及右心室交通;病例报告]

[Aortic root replacement with free-style stentless valve for aorto-left and right ventricular communication due to infective endocarditis; report of a case].

作者信息

Kamikubo Y, Murashita T, Kunishige H, Shiiya N, Matsui Y, Yasuda K

机构信息

Department of Cardiovascular Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Kyobu Geka. 2004 Apr;57(4):329-31.

Abstract

Aortic root abscess remains a major determinant of both early and late results of surgical treatment of endocarditis. This complication rarely progresses to intracardiac shunt followed by cardiac failure. We report a surgical case of a 40-year-old man, who had been diagnosed as prosthetic valve endocarditis with aortic root abscess ruptured into left and right ventricle creating aorto-left and right ventricular communication. Because of complete debridment of infective and/or dead tissue, aortic root replacement was required. We used free-style stentless valve, xenograft, since homograft was not available at the time of operation. We believe that this prosthesis has easier handling and is more resistant to infection, therefore, it might be an option for infective endocarditis with aortic root abscess.

摘要

主动脉根部脓肿仍然是心内膜炎外科治疗早期和晚期结果的主要决定因素。这种并发症很少进展为心内分流并随后导致心力衰竭。我们报告一例40岁男性的手术病例,该患者被诊断为人工瓣膜心内膜炎,伴有主动脉根部脓肿破裂至左、右心室,形成主动脉-左、右心室交通。由于对感染性和/或坏死组织进行了彻底清创,需要进行主动脉根部置换。由于手术时没有同种异体移植物,我们使用了自由式无支架瓣膜、异种移植物。我们认为这种假体操作更简便且更抗感染,因此,它可能是治疗伴有主动脉根部脓肿的感染性心内膜炎的一种选择。

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