带瓣管道主动脉根部置换术后发生心内膜炎并伴有左心室皮肤瘘。
Endocarditis with left ventricular cutaneous fistula after aortic root replacement with a valved conduit.
作者信息
Hollinger Laura, Perryman Lynda, Reardon Michael J
机构信息
Department of Cardiac Surgery, The Methodist Hospital, Houston, Texas 77030, USA.
出版信息
Tex Heart Inst J. 2010;37(2):230-3.
Abstract
Infection after aortic root replacement is uncommon, and it can be fatal. Herein, we present the case of a patient who underwent aortic root replacement with a valved conduit and coronary reimplantation. Prosthetic valve endocarditis and left ventricular cutaneous fistula ensued. Either condition alone could have been fatal. The fistula coursed from the valved conduit through the left ventricular outflow tract, behind the left main coronary artery, and to the skin at the upper sternum. Safe surgical entry into the chest was crucial, due to the free communication between the left ventricle, mediastinum, and skin. We discuss our surgical approach to this unusual combination of conditions, and the postoperative treatment of the patient.
摘要
主动脉根部置换术后感染并不常见，但可能致命。在此，我们报告一例接受带瓣管道主动脉根部置换及冠状动脉再植入术的患者。随后发生了人工瓣膜心内膜炎和左心室皮肤瘘。这两种情况单独出现都可能致命。瘘管从带瓣管道经左心室流出道，在左主冠状动脉后方，通向胸骨上方皮肤。由于左心室、纵隔和皮肤之间存在自由交通，安全进入胸腔进行手术至关重要。我们讨论了针对这种不寻常情况组合的手术方法以及患者的术后治疗。
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