Iba Y, Yamaki F, Matsumura Y, Kouno T, Kouda T, Yamamoto H
Department of Cardiovascular Surgery, Nagano Chuo Hospital, Nagano, Japan.
Kyobu Geka. 2006 Jul;59(7):531-5.
A 60-year-old woman, who had undergone aortic root replacement with composite graft 5 months previously, suffered from anemia and slight fever. Transthoracic echocardiography showed pseudoaneurysm in the aortic root, and blood culture was positive. She was diagnosed with prosthetic valve endocarditis, and surgical intervention was planned. Intraoperatively necrotic tissue and dehiscence of the suture line in the aortic annulus were found. Re-aortic root replacement with Freestyle bioprosthesis and re-hemiarch graft replacement were performed with the omentopexy around the aortic root and the new graft. Antibiotics were administered intravenously for 6 weeks postoperatively. At 7 months after the operation, no prosthetic valve infection had recurred. Although the long-term results of Freestyle bioprosthesis have not been determined, it might be a valuable option for aortic root infection as an alternative to an aortic homograft. In addition, omentopexy might also be effective in the prevention of recurrent prosthetic valve infection.
一名60岁女性，5个月前接受了人工血管复合移植主动脉根部置换术，出现贫血和低热。经胸超声心动图显示主动脉根部假性动脉瘤，血培养阳性。她被诊断为人工瓣膜心内膜炎，并计划进行手术干预。术中发现主动脉瓣环坏死组织和缝线裂开。采用Freestyle生物瓣再次行主动脉根部置换术及半弓人工血管置换术，并在主动脉根部及新人工血管周围行网膜固定术。术后静脉应用抗生素6周。术后7个月，人工瓣膜感染未复发。虽然Freestyle生物瓣的长期效果尚未确定，但作为主动脉同种异体移植的替代方案，它可能是主动脉根部感染的一个有价值的选择。此外，网膜固定术可能对预防人工瓣膜感染复发也有效。
