Hassoulas Joannis, Patrianakos Alexandros P, Parthenakis Fragiskos I, Vardas Panos E
Cardiac Surgery and Heraklion University Hospital Crete, Greece.
Hellenic J Cardiol. 2009 Jul-Aug;50(4):319-23.
We present a 76-year-old woman with infective endocarditis of a prosthetic aortic valve. The course of her illness started with an ischaemic stroke and she was admitted with prolonged fever and an episode of loss of consciousness. Echocardiography revealed acute aortic regurgitation and dehiscence of the prosthetic valve with excessive "rocking motion", aortic abscesses and left ventricular outflow obstruction caused by a semilunar shelf of tissue probably due to endocarditis vegetations. She underwent an urgent surgical procedure that confirmed the echocardiographic findings. Our case report reinforces the value of early diagnosis in the presence of a high clinical suspicion of prosthetic valve endocarditis. An extended workup, including transoesophageal echocardiography, in such a patient with a mechanical valve is mandatory.
我们报告一例76岁患有人工主动脉瓣感染性心内膜炎的女性患者。她的病程始于缺血性中风，因持续发热和一次意识丧失发作入院。超声心动图显示急性主动脉瓣反流、人工瓣膜裂开伴过度“摇摆运动”、主动脉脓肿以及可能因心内膜炎赘生物导致的半月形组织架引起的左心室流出道梗阻。她接受了紧急外科手术，术中所见证实了超声心动图检查结果。我们的病例报告强调了在高度怀疑人工瓣膜心内膜炎时早期诊断的价值。对于此类机械瓣膜患者，进行包括经食管超声心动图在内的全面检查是必不可少的。
