Sheppard R C, Chandrasekaran K, Ross J, Mintz G S
Department of Cardiology, Likoff Cardiovascular Institute, Hahnemann University Hospital, Philadelphia, PA 19102.
J Am Soc Echocardiogr. 1991 May-Jun;4(3):271-6. doi: 10.1016/s0894-7317(14)80027-8.
Para-aortic ring abscess and resulting fistulous communication between adjacent structures frequently occur in prosthetic aortic valve endocarditis but are rarely diagnosed preoperatively. We report a patient who had an abscess involving the aortic-mitral intervalvular fibrosa that eroded into the interatrial septum, causing an interatrial communication with a left-to-right shunt. The abscess was detected by transthoracic echocardiography, but the fistula was only seen by the subsequent transesophageal echocardiogram. To our knowledge, this is the first report of an interatrial fistula secondary to a para-aortic valve abscess and its diagnosis preoperatively. Transesophageal echocardiography should be performed in any patient suspected to have complicated aortic endocarditis.
主动脉旁环形脓肿以及相邻结构之间由此产生的瘘管交通在人工主动脉瓣心内膜炎中经常出现，但术前很少被诊断出来。我们报告一例患者，其脓肿累及主动脉 - 二尖瓣间纤维，该纤维侵蚀至房间隔，导致房间隔交通并伴有左向右分流。脓肿通过经胸超声心动图检测到，但瘘管仅在随后的经食管超声心动图中被发现。据我们所知，这是首例关于主动脉瓣旁脓肿继发房间隔瘘及其术前诊断的报告。对于任何疑似患有复杂性主动脉心内膜炎的患者，都应进行经食管超声心动图检查。
