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矫正型大动脉转位中系统性房室瓣(三尖瓣)细菌性心内膜炎及其外科治疗

Bacterial endocarditis of systemic atrioventricular valve (tricuspid valve) in corrected transposition and its surgical treatment.

作者信息

Akar Haci, Iriz Erkan, Kolbakir Ferşat, Sarac Atilla, Sagkan Olcay

机构信息

Department of Cardiovascular Surgery, State Hospital, Samsun, Turkey.

出版信息

Ann Thorac Cardiovasc Surg. 2005 Jun;11(3):201-3.

Abstract

We describe a case of congenitally corrected transposition of great arteries (CCTGA). Tricuspid valve replacement was performed due to valve dysfunction following bacterial endocarditis. After two weeks' antibiotic therapy haemodynamic stabilisation was obtained and the patient was operated in the third week. On cardiopulmonary bypass with 28 degrees C degree systemic hypothermia, the left atrium was approached transeptally. At exploration, the systemic atrioventricular valve was tricuspid valve and pulmonary atrioventricular valve was in shape of a mitral valve. The posterior leaflet of the tricuspid valve was ruptured and vegetations above it were observed. The valve was excised and a 29 mm St-Jude mechanical heart valve prosthesis implanted using a teflon reinforced separated suture technique. After operation the patient recovered rapidly and following six weeks' antibiotic therapy, the patient was discharged.

摘要

我们描述了一例先天性矫正型大动脉转位(CCTGA)病例。因细菌性心内膜炎后瓣膜功能障碍,进行了三尖瓣置换术。经过两周的抗生素治疗,实现了血流动力学稳定,患者在第三周接受了手术。在28摄氏度全身低温体外循环下,经房间隔进入左心房。探查时,体循环房室瓣为三尖瓣,而肺循环房室瓣呈二尖瓣形态。三尖瓣后叶破裂,可见其上有赘生物。切除该瓣膜,采用聚四氟乙烯加强间断缝合技术植入一枚29毫米的圣犹达机械心脏瓣膜假体。术后患者恢复迅速,经过六周的抗生素治疗后出院。

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