Straumann E, Stulz P, Jenzer H R
Department of Medicine, Kantonsspital Aarau, Basel, Switzerland.
Thorac Cardiovasc Surg. 1990 Oct;38(5):291-4. doi: 10.1055/s-2007-1014037.
This report describes the case of a 24-year-old female heroin addict with large tricuspid valve vegetation, recurrent septic pulmonary emboli, and renal failure, due to immune-complex nephritis. The clinical course was initially complicated by acute hepatitis A. Because of recurrent emboli and persistent fever despite adequate antibiotic therapy she underwent excision of the vegetation ("vegetectomy") and tricuspid valvuloplasty. She was well at follow-up 12 months later with trivial tricuspid regurgitation shown by doppler-echocardiography. Kidney and liver function were normal. Right-heart endocarditis in drug addiction and therapeutic approaches are discussed. In selected cases "vegetectomy" and valvuloplasty offer a promising therapeutic alternative.
本报告描述了一名24岁女性海洛因成瘾者的病例，该患者患有巨大的三尖瓣赘生物、复发性脓毒性肺栓塞以及由免疫复合物性肾炎导致的肾衰竭。临床过程最初因急性甲型肝炎而复杂化。尽管进行了充分的抗生素治疗，但由于复发性栓塞和持续发热，她接受了赘生物切除术（“赘生物切除”）和三尖瓣成形术。12个月后的随访显示她情况良好，多普勒超声心动图显示有轻微的三尖瓣反流。肾功能和肝功能均正常。文中讨论了药物成瘾性右心内膜炎及其治疗方法。在某些特定病例中，“赘生物切除”和瓣膜成形术提供了一种有前景的治疗选择。
