Sueda T, Hamanaka Y, Hayashi S, Matsumoto K, Okamoto M, Matsuura Y
First Department of Surgery, Hiroshima University, School of Medicine, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Jun;40(6):987-91.
A successful repair of infective endocarditis of the tricuspid valve in a drug abuser is reported. A 25-year-old woman with a history of drug addiction was referred to our hospital complaining of high fever despite antibiotic therapy. Blood cultures showed staphylococcal septicemia, and echocardiography revealed large vegetations attached to the tricuspid annulus and massive regurgitation of the tricuspid valve. Blood studies showed renal failure and hematological abnormalities due to septicemia and right ventricular failure. Excision of the vegetation and the posterior leaflet was performed along with annuloplasty (Kay's procedure). The patient's postoperative course was uneventful and subsequent echocardiographic examination disclosed no evidence of recurrence, and insignificant tricuspid valvular regurgitation. Local excision of vegetation and leaflet repair by annuloplasty may be performed in cases with well-circumscribed vegetation and minor leaflet damage.
本文报道了一例成功修复药物滥用者三尖瓣感染性心内膜炎的病例。一名有药物成瘾史的25岁女性因尽管接受了抗生素治疗仍持续高热而转诊至我院。血培养显示为葡萄球菌败血症,超声心动图显示三尖瓣环有大量赘生物附着以及三尖瓣大量反流。血液检查显示由于败血症和右心室衰竭导致肾衰竭和血液学异常。进行了赘生物和后叶切除,并同时进行了瓣环成形术(Kay手术)。患者术后恢复顺利,随后的超声心动图检查未发现复发迹象,三尖瓣反流不明显。对于赘生物边界清晰且瓣叶损伤较小的病例,可进行赘生物局部切除及通过瓣环成形术进行瓣叶修复。