Batias L, Cottier J P, Hommet C, Fichet J, Legras A
Service de réanimation medicale, CHU Tours, hôpital Bretonneau, 2, bd Tonnellé, 37044 Tours 1.
Arch Mal Coeur Vaiss. 2006 Oct;99(10):936-9.
We report the case of a patient with streptococcal mitral endocarditis discovered following an ischaemic cerebrovascular accident. The clinical evolution was marked by the progressive development of a mycotic aneurysm. Surveillance was performed with repeated angio-MRI which provided an indication for embolisation. We demonstrate the value and the current quality of angio-MRI for the diagnosis of mycotic aneurysms, and the value of active management of these lesions which present a high risk of rupture and which are associated with a significant excess mortality. Embolisation can allow earlier cardiac surgery for haemodynamically unstable patients and for those whose neurological state until now contra-indicated intervention.
我们报告了一例在缺血性脑血管意外后发现患有链球菌性二尖瓣心内膜炎的患者。临床病程以真菌性动脉瘤的逐渐发展为特征。通过重复的血管造影磁共振成像（angio-MRI）进行监测，其为栓塞治疗提供了指征。我们证明了血管造影磁共振成像在诊断真菌性动脉瘤方面的价值和当前质量，以及对这些具有高破裂风险且与显著额外死亡率相关的病变进行积极管理的价值。栓塞治疗可以使血流动力学不稳定的患者以及迄今为止神经状态禁忌干预的患者更早地接受心脏手术。
