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用于起搏器导线心内膜炎的三尖瓣修复术。

Tricuspid-valve repair for pacemaker leads endocarditis.

作者信息

Iezzi Federica, Cini Roberto, Sordini Paolo

机构信息

Division of Cardiac Surgery, Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy.

出版信息

BMJ Case Rep. 2010 Dec 20;2010:bcr0120102673. doi: 10.1136/bcr.01.2010.2673.

Abstract

In non-addicted patients, several states, such as permanent pacemakers, can provide the predisposing factors for tricuspid-valve endocarditis. In this report, we present a case of a 66-year-old man with pacemaker lead infection and tricuspid-native-valve endocarditis, related to Staphylococcus hominis, very rare cause of infective endocarditis that carries a high-mortality risk. Surgery was indicated for the patient due to persistent enlarging vegetation on the tricuspid valve, severe tricuspid regurgitation, septic pulmonary emboli and finally uncompensated respiratory and heart failure. Many ingenious methods have been devised to repair the tricuspid valve in patients with infective endocarditis. Valve replacement, however, is hazardous due to the possibility of prosthetic infection, and we choose to repair the native valve. The patient has now been weel for 3 years.

摘要

在非成瘾患者中,诸如永久性起搏器等几种情况可成为三尖瓣心内膜炎的诱发因素。在本报告中,我们呈现了一例66岁男性患者,患有起搏器导线感染及三尖瓣自身瓣膜心内膜炎,病原体为腐生葡萄球菌,这是感染性心内膜炎非常罕见的病因,且具有高死亡风险。由于三尖瓣上的赘生物持续增大、严重的三尖瓣反流、脓毒性肺栓塞以及最终出现失代偿性呼吸和心力衰竭,该患者需要进行手术治疗。已经设计出许多巧妙的方法来修复感染性心内膜炎患者的三尖瓣。然而,瓣膜置换因存在人工瓣膜感染的可能性而具有危险性,因此我们选择修复自身瓣膜。该患者现已康复3年。

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