Cardiovascular Surgery Department, Ogaki Tokushukai Hospital, Ogaki-city, Gifu, Japan.
Ann Thorac Surg. 2010 Mar;89(3):959-61. doi: 10.1016/j.athoracsur.2009.07.054.
A 71-year-old man presented with general fatigue associated with syncope and fever, and was admitted to our hospital and treated with antibiotics for pneumonia. On day 10 after admission, cardiac echocardiography showed a ventricular septal perforation and giant vegetation floating in the right ventricle near the tricuspid valve, which had not been detected at the time of admission. An emergency operation (including vegetation excision, debridement, ventricular septal perforation patch closure, and tricuspid valve replacement) was performed. A permanent pacemaker was implanted on postoperative day 34, and the patient was discharged without any complications. A culture of the excised vegetation and blood culture revealed methicillin-susceptible Staphylococcus aureus. There has been no previous report of a presenting ventricular septal perforation caused by right-sided infective endocarditis.
一位 71 岁男性因全身乏力伴晕厥和发热就诊，收住入院并接受肺炎抗生素治疗。入院后第 10 天，心脏超声心动图显示室间隔穿孔和漂浮在右心室靠近三尖瓣的巨大赘生物，这些在入院时并未检测到。紧急手术（包括切除赘生物、清创、室间隔穿孔修补和三尖瓣置换）进行。术后第 34 天植入永久性起搏器，患者无任何并发症出院。切除的赘生物和血培养均显示耐甲氧西林金黄色葡萄球菌。目前尚未有报告指出右侧感染性心内膜炎会导致新发的室间隔穿孔。
