Kanamitsu Hitoshi, Yamada Yukio, Kusuyama Takanori
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.
Kyobu Geka. 2011 Jun;64(6):500-2.
The choice of simultaneous or staged surgery in patients with valvular diseases and abdominal aortic aneurysms (AAA) remains controversial. We present a case of simultaneous surgery of double valve replacement and abdominal aorta replacement in a patient with infective endocarditis. A 74-year-old woman was admitted to our hospital because of general fatigue and appetite loss. Computed tomography (CT) scan showed a infrarenal AAA measuring 99 x 67 mm. Echocardiography showed severe regurgitation of mitral valve and aortic valve with vegetations. Electrocardiogram showed atrial fibrillation. She was diagnosed as heart failure due to infective endocarditis and treated with antibiotics, diuretics and catecholamine. However, heart failure did not improve; the patient underwent double valve replacement, pulmonary vein isolation and abdominal aorta replacement simultaneously. Postoperative course was uneventful.
对于患有瓣膜疾病和腹主动脉瘤（AAA）的患者，选择同期手术还是分期手术仍存在争议。我们报告一例患有感染性心内膜炎的患者同期进行双瓣膜置换和腹主动脉置换手术的病例。一名74岁女性因全身乏力和食欲减退入住我院。计算机断层扫描（CT）显示肾下腹主动脉瘤大小为99×67mm。超声心动图显示二尖瓣和主动脉瓣重度反流并伴有赘生物。心电图显示心房颤动。她被诊断为感染性心内膜炎导致的心力衰竭，并接受了抗生素、利尿剂和儿茶酚胺治疗。然而，心力衰竭并未改善；该患者同期进行了双瓣膜置换、肺静脉隔离和腹主动脉置换。术后病程顺利。
