The Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Ann Thorac Surg. 2012 Jul;94(1):e5-6. doi: 10.1016/j.athoracsur.2012.01.052.
New technologies in the management of congenital and acquired heart disease may be associated with unfamiliar complications that may require repeated surgical intervention. A high index of suspicion for unusual problems and close collaboration between cardiologists and surgeons is essential when adopting evolving technologies. We report the case of near total obstruction of a 2.5-month-old implanted Melody percutaneous pulmonary valve (PPV) with a thrombus mimicking saddle embolus causing right heart failure and hemodynamic collapse. This obstruction necessitated emergency surgery and homograft replacement. Cultures and pathologic examination revealed fungal thrombus with Aspergillus fumigatus. Subsequently, the patient had rapid improvement, received antifungal treatment, and has shown excellent cardiac and systemic recovery up to 1 year after surgery.
新技术在先天性和后天性心脏病的治疗中可能会出现一些不常见的并发症，这可能需要反复的手术干预。在采用新兴技术时，心脏病专家和外科医生之间需要高度怀疑不常见的问题，并密切合作。我们报告了一例 2.5 个月大的植入式 Melody 经皮肺动脉瓣（PPV）几乎完全阻塞的病例，其血栓类似于鞍状栓子，导致右心衰竭和血流动力学崩溃。这种阻塞需要紧急手术和同种异体移植置换。培养和病理检查显示真菌血栓合并烟曲霉菌。随后，患者病情迅速改善，接受了抗真菌治疗，并且在手术后 1 年的随访中，心脏和全身恢复情况良好。
