Futagami Daisuke, Hamamoto Masaki
Department of Cardiovascular Surgery, Onomichi General Hospital, Onomichi, Japan.
Kyobu Geka. 2012 Mar;65(3):223-6.
A 57-year-old man underwent mitral valve replacement and tricuspid annuloplasty for mitral and tricuspid regurgitation. Pacemaker implantation was conducted because of postoperative sick sinus syndrome 2 months after the operation. One year later, the patient was readmitted to the hospital because of high fever. Echocardiography showed 2 vegetations of 10 mm in diameter attached to the mitral mechanical valve. No vegetations were detected on the tricuspid valve or the pacemaker leads. Mitral valve re-replacement was urgently performed under the diagnosis of prosthetic valve endocarditis caused by Staphylococcus aureus. One month after the reoperation, pacemaker infection developed in spite of suitable infection control by daily intravenous injection of sensitive antibiotics. We proceeded to place a temporary pacing wire and extracted the entire permanent pacing system. A new permanent pacemaker was implanted 5 days later. The patient was discharged on the 62th postoperative day without recurrence of infection.
一名57岁男性因二尖瓣和三尖瓣反流接受了二尖瓣置换术和三尖瓣环成形术。术后2个月因病态窦房结综合征进行了起搏器植入。1年后，患者因高热再次入院。超声心动图显示二尖瓣机械瓣上附着有2个直径为10mm的赘生物。三尖瓣或起搏器导线上未检测到赘生物。在诊断为金黄色葡萄球菌引起的人工瓣膜心内膜炎后，紧急进行了二尖瓣再次置换术。再次手术后1个月，尽管每天静脉注射敏感抗生素进行了适当的感染控制，但仍发生了起搏器感染。我们放置了临时起搏导线并取出了整个永久性起搏系统。5天后植入了新的永久性起搏器。患者术后第62天出院，感染未复发。
